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The Diagnostic Value of Interleukin-6 and Interleukin-8 for Early Prediction of Bacteremia and Sepsis in Children With Febrile Neutropenia and Cancer

Urbonas, Vincas MD; Eidukaitė, Audronė MD, PhD; Tamulienė, Indrė MD

Journal of Pediatric Hematology/Oncology: March 2012 - Volume 34 - Issue 2 - p 122–127
doi: 10.1097/MPH.0b013e3182446a60
Original Articles

Background and Aim: Early diagnosis of sepsis in children with febrile neutropenia and cancer still remains a challenge for modern medicine because of lack of specific laboratory markers and clinical signs especially at the beginning of the infection. The objective of this study was to evaluate the ability of interleukin-6 and interleukin-8 to predict bacteremia and sepsis during the first 2 days in oncohematologic patients with febrile neutropenia.

Patients and Methods: A total of 61 febrile neutropenic episodes in 37 children were studied. Serum samples were collected on day 1 and day 2 from the onset of fever and analyzed using an automated random access analyzer.

Results: Neutropenic children with febrile episodes were classified into the following 2 groups: (1) fever of unknown origin group—patients with a negative blood culture—and (2) bacteremia/sepsis group—patients with a positive blood culture or clinical sepsis. High negative predictive values were found on day 1 for interleukin-6 and interleukin-8 (89% and 82%, respectively) for exclusion of bacteremia/sepsis.

Conclusions: These interleukins could be used as a screening tool for the rejection of sepsis or bacteremia on the first day of fever in neutropenic children with cancer.

*Department of Immunology, Center for Innovative Medicine, National Research Institute

Department of Hematology, Oncology and Transfusion Medicine, Vilnius University Children’s Hospital, Vilnius, Lithuania

Supported by The Lithuanian Foundation of Science and Studies.

The authors declare no conflict of interest.

Reprints: Vincas Urbonas, MD, Vilnius University Hospital Santariskiu Klinikos, Centre of Hematology, Oncology and Transfusion Medicine, Santariskiu 2, Vilnius LT 08661, Lithuania (e-mail: vincas.urbonas@postgrad.manchester.ac.uk).

Received February 8, 2011

Accepted November 29, 2011

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.