Serum caspase-cleaved cytokeratin-18 fragment as a prognostic biomarker in hematological patients with febrile neutropenia
| Autor: | Marika Lappalainen, Anna Kaisa Purhonen, Matti Vänskä, Sini Korpelainen, Sari Hämäläinen, Esa Jantunen, Carina Intke, Kari Pulkki, Auni Juutilainen |
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| Přispěvatelé: | Department of Clinical Chemistry and Hematology, HUSLAB, Tampere University, Department of Internal medicine, Seinäjoen keskussairaala VA |
| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty GUIDELINES Gastroenterology General Biochemistry Genetics and Molecular Biology Procalcitonin law.invention DEFINITIONS Sepsis 03 medical and health sciences 0302 clinical medicine law Internal medicine medicine Humans Blood culture PROCALCITONIN Non-Hodgkin lymphoma Febrile Neutropenia Acute myeloid leukemia Hematology medicine.diagnostic_test Keratin-18 business.industry Septic shock M30 Caspase-cleaved cytokeratin-18 SEPTIC SHOCK Area under the curve General Medicine medicine.disease Prognosis Intensive care unit Severe sepsis APOPTOSIS 030104 developmental biology C-Reactive Protein CELL-DEATH ROC Curve 030220 oncology & carcinogenesis Caspases 1182 Biochemistry cell and molecular biology 3111 Biomedicine business Febrile neutropenia Biomarkers |
| Zdroj: | Clinical and experimental medicine. 22(1) |
| ISSN: | 1591-9528 |
| Popis: | The study aim was to determine the benefit of the measurement of serum caspase-cleaved cytokeratin-18 (CK-18) fragment as a prognostic marker of febrile neutropenia (FN) in hematological patients. The study population consisted of 86 consecutive patients with FN who received intensive chemotherapy for hematological malignancy at the adult hematology ward of Kuopio University Hospital. Twenty-three patients (27%) had acute myeloid leukemia, and 63 patients (73%) were autologous stem cell transplant recipients. Serum caspase-cleaved CK-18 fragment M30, C-reactive protein (CRP) and procalcitonin (PCT) were measured at the onset of FN (d0), on day 1 (d1), and on day 2 (d2). Eight patients (9%) developed severe sepsis, including three patients with septic shock. Eighteen patients (21%) had a blood culture-positive infection. Serum CK-18 fragment peaked on the first day after fever onset in patients with severe sepsis. Higher CK-18 level was associated with severe sepsis, intensive care unit treatment, and fatal outcome, but not with blood culture positivity. In ROC curve analysis, d1 serum CK-18 fragment predicted severe sepsis with an area under the curve (AUC) of 0.767, CRP with an AUC of 0.764, and PCT with an AUC of 0.731. On d2, the best predictive capacity was observed for CRP with an AUC of 0.832. The optimal cutoff of caspase-cleaved CK-18 fragment M30 for predicting severe sepsis was 205 U/L on d1. In hematological patients, serum CK-18 fragment was found to be a potential prognostic marker of severe sepsis at early stages of FN. |
| Databáze: | OpenAIRE |
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