Outcome of Tocilizumab Treatment in Febrile Neutropenic Children with Severe Sepsis/Septic Shock in a Single-Center Retrospective Case Series.

Autor: Chen SH; Division of Pediatric Hematology-Oncology, College of Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan 333, Taiwan., Chang TY; Division of Pediatric Hematology-Oncology, College of Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan 333, Taiwan., Wang YL; Division of Pediatric Hematology-Oncology, College of Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan 333, Taiwan., Lee EP; Division of Pediatric Critical Care Medicine, College of Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan 333, Taiwan., Lin JJ; Division of Pediatric Critical Care Medicine, College of Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan 333, Taiwan., Hsiao YW; Department of Nursing, College of Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan 333, Taiwan., Jaing TH; Division of Pediatric Hematology-Oncology, College of Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan 333, Taiwan., Yang CP; Division of Pediatric Hematology-Oncology, College of Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan 333, Taiwan., Hung IJ; Division of Pediatric Hematology-Oncology, College of Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan 333, Taiwan.
Jazyk: angličtina
Zdroj: Cancers [Cancers (Basel)] 2024 Apr 16; Vol. 16 (8). Date of Electronic Publication: 2024 Apr 16.
DOI: 10.3390/cancers16081512
Abstrakt: Purpose: To assess the efficacy of an IL-6 blockade with tocilizumab on treatment outcome of severe sepsis/septic shock in children with febrile neutropenia.
Methods: We performed a retrospective study of febrile neutropenic patients younger than 18 years old who developed severe sepsis/septic shock at a single medical center between November 2022 and October 2023.
Results: Seven patients with febrile neutropenia complicated with severe sepsis/septic shock were identified. Four of seven patients received tocilizumab in addition to standard of care. The median IL-6 level before administration of tocilizumab was 14,147 pg/mL (range: 672-30,509 pg/mL). All four patients successfully recovered from severe sepsis/septic shock. Three of seven patients received standard of care without tocilizumab. IL-6 levels were checked intwo2 patients, with a median of 1514.5 (range: 838-2191). Only one of three (33%) patients without tocilizumab therapy made a full recovery from severe sepsis/septic shock. The mortality rate was higher in patients without tocilizumab therapy compared to patients with tocilizumab therapy (67% vs. 0%).
Conclusions: Administration of tocilizumab reduced mortality of severe sepsis/septic shock in children with febrile neutropenia. However, it warrants confirmation with a larger number of patients and a longer follow-up.
Databáze: MEDLINE
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