Performance of Interleukin-6 and Interleukin-8 serum levels in pediatric oncology patients with neutropenia and fever for the assessment of low-risk

A prospective study was performed to assess the potential value of IL-6, IL-8 and C-reactive protein serum levels to predict severe bacterial infection or bacteremia in febrile neutropenic children with cancer during chemotherapy. Statistical test used: Friedman test, Wilcoxon-Test, Kruskal-Wallis H test, Mann-Whitney U-Test and Receiver Operating Characteristics.The analysis of cytokine levels measured at the onset of fever indicated that IL-6 and IL-8 are useful to define a possible group of patients with low risk of sepsis. In predicting bacteremia or severe bacterial infection, IL-6 was the best predictor with the optimum IL-6 cut-off level of 42 pg/ml showing a high sensitivity (90%) and specificity (85%).These findings may have clinical implications for risk-based antimicrobial treatment strategies.Infections are still the major cause of treatment-related morbidity and mortality in cancer patients [1]. The malignant disease and the intensive chemotherapy may cause an impaired host defence to infection. Key factors are the intensity and duration of neutropenia, but a decreased function of granulocytes and disturbances of natural barriers may substantially add to the risk of serious infections [2]. Patients with chemotherapy-related neutropenia and fever are usually hospitalized and treated on empirical intravenous broad-spectrum antibiotic regimens until the patient is afebrile, the blood cultures are negative and the absolute neutrophile count (ANC) has recovered to > 500/μl [3]. Patients without a documented clinical focus of infection and without microbiological evidence for a causative organism usually have a short duration of fever and low risk of developing clinical complications. Unfortunately, culture results become available only after 2 or 3 days and clinical information at fever onset that can be used to establish prediction rules lacks sensitivity and specificity. There are a number of studies that have evaluated diverse markers of inflammation as p