Plasma levels of procalcitonin and eight additional inflammatory molecules in febrile neutropenic patients

• Main Authors: Letícia Carvalho Neuenschwander, Henrique Bittencourt, Ana Flávia Tibúrcio Ribeiro, Antônio Lúcio Teixeira, Mauro M. Teixeira, Jairo Cerqueira Teixeira, Vandack Nobre
• Format: Article
• Language: English
• Published: Faculdade de Medicina / USP 2011-01-01
• Series: Clinics
• Subjects: Febrile neutropenia; Inflammatory markers; Procalcitonin; Sensitivity; Specificity
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322011001000006

OBJECTIVE: This study aimed to examine the association between different inflammatory markers and specific clinical endpoints in patients with febrile neutropenia. METHOD: We prospectively evaluated the expression of procalcitonin (PCT), interleukin 8 (IL-8), induced protein-10, tumor necrosis factor alpha (TNF-a), two soluble TNF-a receptors (sTNF-R I and sTNF-R II), monocyte chemotactic protein-1 (MCP-1), macrophage inflammatory protein-1 alpha, and eotaxin in 37 episodes of febrile neutropenia occurring in 31 hospitalized adult onco-hematologic patients. Peripheral blood samples were collected in the morning at inclusion (day of fever onset) and on days 1, 3, and 7 after the onset of fever. Approximately 2-3 ml of plasma was obtained from each blood sample and stored at -80°C. RESULTS: The sTNF-R II level at inclusion (day 1), the PCT level on the day of fever onset, and the change (day 3 - day 1) in the IL-8 and eotaxin levels were significantly higher in patients who died during the 28-day follow-up. A requirement for early adjustment of antimicrobial treatment was associated with higher day 3 levels of IL-8, sTNF-R II, PCT, and MCP-1. CONCLUSION: Procalcitonin, sTNF-R II, IL-8, MCP-1, and eotaxin could potentially be used to assess the risk of death and the requirement for early adjustment of antimicrobial treatment in febrile, neutropenic onco-hematologic patients. The levels of the other markers showed no association with any of the evaluated endpoints.