Why the study?
Do serum concentrations of cytokines and acute-phase reactants differentiate true bacteremia from fever due to other causes in neutropenic children with cancer?
Do serum concentrations of cytokines and acute-phase reactants differentiate true bacteremia from fever due to other causes in neutropenic children with cancer?
Serum cytokine and acute-phase protein levels are related to the febrile response in neutropenic children with cancer but are not sufficiently accurate to diagnose bacterial etiology at the individual level.
SAA may aid early bacteremia screening in febrile neutropenia; leaves open reliable individual-level etiology prediction.
Serum concentrations of tumor necrosis factor-alpha (TNF alpha), interleukin (IL)-1 beta, IL-6, and the acute-phase reactants C-reactive protein (CRP) and serum amyloid A (SAA) were measured on admission in 46 neutropenic children with cancer in 81 episodes of fever. The aim was to find out whether any of these variables would differentiate true bacteremia from fever due to other causes. In most episodes serum concentrations of TNF alpha and IL-1 beta were elevated. IL-6 was detectable in 68%, but the serum concentration was elevated in only 15%. SAA proved to be more sensitive than CRP for the early detection of bacteremia. However, not even SAA was sufficiently accurate at the individual level. We conclude that the cytokine and acute-phase protein levels found were related to the febrile response but did not correlate with documented bacterial etiology.
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Riikonen et al. (1992) studied this question.
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