Significance of interleukin-6 (IL-6) and C-reactive protein (CRP) in children and young adults with febrile neutropenia during chemotherapy for cancer

A prospective study

Narendra Chaudhary, Kranthi Kosaraju, Kamalakshi Bhat, Indira Bairy, Anupama Borker

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

OBJECTIVES:: We evaluated the usefulness of interleukin-6 (IL-6) and C-reactive protein (CRP) at the onset of febrile neutropenia and 72 hours later, in identifying risk groups and assessing response to antibiotic therapy. METHODS:: All episodes of febrile neutropenia were divided in 3 study groups-microbiologically documented infection (MDI), clinically documented infection (CDI), and fever of unknown origin (FUO). Three outcome groups were defined as those responding to first-line antibiotics (R1), those responding to second-line antibiotics (R2), and those requiring antifungal therapy (RAF). Median values of IL-6 and CRP were compared between the groups. RESULTS:: There were 57 episodes of febrile neutropenia among 26 patients younger than 25 years during 1 year of study period. On day 1, median IL-6 level was significantly lower in FUO group compared with CDI+MDI groups combined (P<0.001). Rise in CRP on day 3 was highly significant to differentiate MDI group from other 2 groups (P<0.001). The CRP also increased significantly on day 3 in RAF (P<0.001) and R2 (P=0.002) groups than in R1 group. CONCLUSIONS:: Low level of IL-6 may help differentiate patients with FUO from those with documented infections. A rising CRP is indicative of serious infection.

Original languageEnglish
Pages (from-to)617-623
Number of pages7
JournalJournal of Pediatric Hematology/Oncology
Volume34
Issue number8
DOIs
Publication statusPublished - 11-2012

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Febrile Neutropenia
C-Reactive Protein
Young Adult
Interleukin-6
Prospective Studies
Drug Therapy
Fever of Unknown Origin
Infection
Neoplasms
Anti-Bacterial Agents
Therapeutics

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

Cite this

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title = "Significance of interleukin-6 (IL-6) and C-reactive protein (CRP) in children and young adults with febrile neutropenia during chemotherapy for cancer: A prospective study",
abstract = "OBJECTIVES:: We evaluated the usefulness of interleukin-6 (IL-6) and C-reactive protein (CRP) at the onset of febrile neutropenia and 72 hours later, in identifying risk groups and assessing response to antibiotic therapy. METHODS:: All episodes of febrile neutropenia were divided in 3 study groups-microbiologically documented infection (MDI), clinically documented infection (CDI), and fever of unknown origin (FUO). Three outcome groups were defined as those responding to first-line antibiotics (R1), those responding to second-line antibiotics (R2), and those requiring antifungal therapy (RAF). Median values of IL-6 and CRP were compared between the groups. RESULTS:: There were 57 episodes of febrile neutropenia among 26 patients younger than 25 years during 1 year of study period. On day 1, median IL-6 level was significantly lower in FUO group compared with CDI+MDI groups combined (P<0.001). Rise in CRP on day 3 was highly significant to differentiate MDI group from other 2 groups (P<0.001). The CRP also increased significantly on day 3 in RAF (P<0.001) and R2 (P=0.002) groups than in R1 group. CONCLUSIONS:: Low level of IL-6 may help differentiate patients with FUO from those with documented infections. A rising CRP is indicative of serious infection.",
author = "Narendra Chaudhary and Kranthi Kosaraju and Kamalakshi Bhat and Indira Bairy and Anupama Borker",
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T1 - Significance of interleukin-6 (IL-6) and C-reactive protein (CRP) in children and young adults with febrile neutropenia during chemotherapy for cancer

T2 - A prospective study

AU - Chaudhary, Narendra

AU - Kosaraju, Kranthi

AU - Bhat, Kamalakshi

AU - Bairy, Indira

AU - Borker, Anupama

PY - 2012/11

Y1 - 2012/11

N2 - OBJECTIVES:: We evaluated the usefulness of interleukin-6 (IL-6) and C-reactive protein (CRP) at the onset of febrile neutropenia and 72 hours later, in identifying risk groups and assessing response to antibiotic therapy. METHODS:: All episodes of febrile neutropenia were divided in 3 study groups-microbiologically documented infection (MDI), clinically documented infection (CDI), and fever of unknown origin (FUO). Three outcome groups were defined as those responding to first-line antibiotics (R1), those responding to second-line antibiotics (R2), and those requiring antifungal therapy (RAF). Median values of IL-6 and CRP were compared between the groups. RESULTS:: There were 57 episodes of febrile neutropenia among 26 patients younger than 25 years during 1 year of study period. On day 1, median IL-6 level was significantly lower in FUO group compared with CDI+MDI groups combined (P<0.001). Rise in CRP on day 3 was highly significant to differentiate MDI group from other 2 groups (P<0.001). The CRP also increased significantly on day 3 in RAF (P<0.001) and R2 (P=0.002) groups than in R1 group. CONCLUSIONS:: Low level of IL-6 may help differentiate patients with FUO from those with documented infections. A rising CRP is indicative of serious infection.

AB - OBJECTIVES:: We evaluated the usefulness of interleukin-6 (IL-6) and C-reactive protein (CRP) at the onset of febrile neutropenia and 72 hours later, in identifying risk groups and assessing response to antibiotic therapy. METHODS:: All episodes of febrile neutropenia were divided in 3 study groups-microbiologically documented infection (MDI), clinically documented infection (CDI), and fever of unknown origin (FUO). Three outcome groups were defined as those responding to first-line antibiotics (R1), those responding to second-line antibiotics (R2), and those requiring antifungal therapy (RAF). Median values of IL-6 and CRP were compared between the groups. RESULTS:: There were 57 episodes of febrile neutropenia among 26 patients younger than 25 years during 1 year of study period. On day 1, median IL-6 level was significantly lower in FUO group compared with CDI+MDI groups combined (P<0.001). Rise in CRP on day 3 was highly significant to differentiate MDI group from other 2 groups (P<0.001). The CRP also increased significantly on day 3 in RAF (P<0.001) and R2 (P=0.002) groups than in R1 group. CONCLUSIONS:: Low level of IL-6 may help differentiate patients with FUO from those with documented infections. A rising CRP is indicative of serious infection.

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