Biomarkers and Fever in Children with Cancer: Kinetics and Levels According to Final Diagnosis.

Autor: de Lucio Delgado A; Pediatric Department, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain., Villegas Rubio JA; Pediatric Department, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain., Rey Galan C; Pediatric Intensive Care, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain., Prieto García B; Clinical Biochemistry, Laboratory of Medicine, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain., González Expósito MLR; Institute of Cancer Research, London SW3 6JB, UK., Solís Sánchez G; Service of the Neonatology Unit, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain.
Jazyk: angličtina
Zdroj: Children (Basel, Switzerland) [Children (Basel)] 2021 Nov 09; Vol. 8 (11). Date of Electronic Publication: 2021 Nov 09.
DOI: 10.3390/children8111027
Abstrakt: We investigated the kinetics of CRP, PCT, IL-6 and MR-proADM in a cohort of consecutive febrile patients with cancer in order to test the hypothesis that higher plasma concentrations and the absence of a rapid decrease in peak values would be associated with disease severity. (1) Method: A prospective descriptive and analytical study of patients with cancer and fever (≤18 years of age) at a University Hospital was carried out between January 2018 and December 2019. Information collected: sex, age, diagnosis, date and symptoms at diagnosis and medical history. The episodes were classified into three groups: bacterial infection, non-bacterial infection and systemic inflammatory response syndrome (SIRS). (2) Results: One hundred and thirty-four episodes were included. Bacterial infection criteria were met in 38 episodes. Biomarkers were measured at four different points: baseline, at 12-24 h, at 25-48 h and at 49-72 h. All the biomarkers evaluated decreased after the peak level was reached. IL-6 and MR-proADM showed a trend towards higher levels in the SIRS group although this rise was statistically significant only for IL-6 ( p < 0.005). Bacterial infections more frequently presented values of PCT above the cut-off point (>0.5 ng/mL) at 12-24 h. (3) Conclusion: In our experience, IL-6 kinetics is faster than PCT kinetics and both are faster than CRP in patients with fever and cancer who present a good outcome. Patients with a good evolution show a rapid increase and decrease of PCT and particularly of IL-6 levels.
Databáze: MEDLINE