Skip Navigation LinksHome > April 2013 - Volume 35 - Issue 3 > IL-8 Predicts Pediatric Oncology Patients With Febrile Neutr...
Journal of Pediatric Hematology/Oncology:
doi: 10.1097/MPH.0b013e318281e653
Original Articles

IL-8 Predicts Pediatric Oncology Patients With Febrile Neutropenia at Low Risk for Bacteremia

Cost, Carrye R. MD*; Stegner, Martha M. MD*; Leonard, David PhD; Leavey, Patrick MD*

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Abstract

Introduction: Despite a low bacteremia rate, pediatric oncology patients are frequently admitted for febrile neutropenia. A pediatric risk prediction model with high sensitivity to identify patients at low risk for bacteremia is not available. We performed a single-institution prospective cohort study of pediatric oncology patients with febrile neutropenia to create a risk prediction model using clinical factors, respiratory viral infection, and cytokine expression.

Materials and Methods: Pediatric oncology patients with febrile neutropenia were enrolled between March 30, 2010 and April 1, 2011 and managed per institutional protocol. Blood samples for C-reactive protein and cytokine expression and nasopharyngeal swabs for respiratory viral testing were obtained. Medical records were reviewed for clinical data. Statistical analysis utilized mixed multiple logistic regression modeling.

Results: During the 12-month period, 195 febrile neutropenia episodes were enrolled. There were 24 (12%) episodes of bacteremia. Univariate analysis revealed several factors predictive for bacteremia, and interleukin (IL)-8 was the most predictive variable in the multivariate stepwise logistic regression. Low serum IL-8 predicted patients at low risk for bacteremia with a sensitivity of 0.9 and negative predictive value of 0.98.

Conclusions: IL-8 is a highly sensitive predictor for patients at low risk for bacteremia. IL-8 should be utilized in a multi-institution prospective trial to assign risk stratification to pediatric patients admitted with febrile neutropenia.

© 2013 Lippincott Williams & Wilkins, Inc.

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