Serum Levels of IL-1 beta, sIL-2R, IL-6, IL-8, and TNF-alpha in Febrile Children with Cancer and Neutropenia

Abstract

Serum levels of interleukin-1 beta (IL-1beta), soluble interleukin 2 receptors (sIL-2R), interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor-alpha (TNF-alpha) were measured to predict some characteristics of febrile episodes in children with cancer and neutropenia. Forty-eight episodes of febrile neutropenia were determined in 23 pediatric cancer patients, including 35 febrile episodes without identifiable source, 7 episodes of bacteremia due to Gram-negative organisms and 4 due to Gram-positive organisms, and 2 fungal infections. Interleukin-6, sIL-2R, and IL-8 levels were significantly higher at the beginning of the febrile episodes than those of controls (p < 0.001, p < 0.001, and p < 0.001). Interleukin-6, slL-2R, and IL-8 levels were higher in patients with bacteremia due to Gram-negative organisms than in those with Gram-positive ones (p = 0.042, p = 0.006, and p = 0.023, respectively). TNF-alpha and IL-1beta levels were similar in febrile episodes and controls (p > 0.05). In conclusion, sIL-2R, IL-6, and IL-8 levels may be helpful in the prediction of infection in febrile cancer patients with neutropenia and measurements of IL-1beta and TNF-alpha were not useful for identifying the presence and the type of infection in febrile neutropenic episodes in children.

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

“…Our study confirmed the previous results of Persson et al 31 showing that IL-6 and IL-8 can be used for the exclusion of children with bacteremia. In contrast to reports of other authors, [28][29][30] we found that it was not possible to predict bacteremia in children with cancer and fever because of low values of sensitivity and PPV.…”

“…Stryjewski et al 27 found that IL-8 and procalcitonin (PCT) in combination were good diagnostic markers of bacterial sepsis in children with febrile neutropenia, whereas Soker et al28 showed that sIL-2R, IL-6, and IL-8 may be helpful in the prediction of infection in children with febrile cancer and neutropenia. A prospective, multicenter trial was performed by Santolaya et al29 in which predictors of severe sepsis not clinically apparent during the first 24 hours of hospitalization in children with cancer and febrile neutropenia were evaluated.…”

Interleukin-5, interleukin-6, interleukin-8 and tumour necrosis factor-alpha levels obtained within 24-h of admission do not predict high-risk infection in children with febrile neutropenia

“…[18] TNF-α is involved in the regulation of a wide range of biological processes. Similar to our experience, Soker et al, [19] did not find TNF-α to be useful. Abrahamsson et al, [10] reported TNF-α production to be impaired in neutropenic children.…”

Circulating Inflammatory Mediators during Start of Fever in Differential Diagnosis of Gram-Negative and Gram-Positive Infections in Leukopenic Rats

“…Circulating proinflammatory mediators such as interleukin-6 (IL-6), IL-8, macrophage inflammatory protein-2 (MIP-2), Creactive protein (CRP), and, more recently, procalcitonin (PCT) have been suggested to be predictive for a systemic microbial bloodstream infection in neutropenic hosts (4,8,11,12,24,35,36). However, the early cellular response to gramnegative and gram-positive bacteria is still unclear, and little is known about how the profile of these mediators during severe leukopenia might be affected by different microbial stimuli.…”