Serum levels of mannose-binding lectin and the risk of fever in neutropenia pediatric cancer patients
| Autor: | Roland A. Ammann, Kurt Leibundgut, Andreas Hirt, Maria Otth, A. Ridolfi Luethy, Christoph Aebi, Luregn J. Schlapbach |
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| Rok vydání: | 2007 |
| Předmět: |
Male
medicine.medical_specialty Neutropenia Adolescent Fever Antineoplastic Agents chemical and pharmacologic phenomena Mannose-Binding Lectin Sensitivity and Specificity Gastroenterology Risk Factors Internal medicine medicine Humans Child Prospective cohort study Mannan-binding lectin Brain Neoplasms business.industry Cancer Sarcoma Hematology bacterial infections and mycoses medicine.disease Pediatric cancer Pneumonia Oncology Child Preschool Hematologic Neoplasms Bacteremia Pediatrics Perinatology and Child Health Immunology Female Disease Susceptibility Neoplasm Recurrence Local Complication business |
| Zdroj: | Pediatric Blood & Cancer. 49:11-16 |
| ISSN: | 1545-5017 1545-5009 |
| Popis: | Fever in neutropenia (FN) is a frequent complication in pediatric oncology. Deficiency of mannose-binding lectin (MBL), an important component of innate immunity, is common due to genetic polymorphisms, but its impact on infections in oncologic patients is controversial. This study investigated whether MBL serum levels at cancer diagnosis are associated with the development of FN in pediatric cancer patients.Serum MBL was measured using ELISA. Frequency, duration, and cause of FN were assessed retrospectively. Association with MBL level was analyzed using uni- and multivariate Poisson regression taking into account both intensity and duration of chemotherapy.In 94 children, with a cumulative follow-up time of 81.7 years, 177 FN episodes were recorded. Patients with both very low MBL levels (100 microg/L; risk ratio (RR), 1.93; 95% CI, 1.14-3.28; P = 0.014) and normal MBL levels (or=1,000 microg/L; RR, P = 0.011) had significantly more frequent FN episodes than patients with low MBL levels (100-999 microg/L). Patients with very low MBL levels had significantly more episodes of FN with severe bacterial infection (bacteremia or pneumonia; RR, 4.49; 1.69 = 11.8; P = 0.003), while those with normal MBL levels had more FN episodes with no microbial etiology identified (RR, 1.85; 1.14 = 3.03; P = 0.014).Very low MBL levels are associated with more frequent FN episodes, mainly due to severe bacterial infections. The surprising finding that children with normal MBL levels had more frequent FN episodes than those with low MBL levels needs testing in prospective studies. |
| Databáze: | OpenAIRE |
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