IL-8 predicts pediatric oncology patients with febrile neutropenia at low risk for bacteremia

Carrye R. Cost, Martha M. Stegner, David Leonard, Patrick Leavey

Research output: Contribution to journalArticle

7 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)206-211
Number of pages6
JournalJournal of Pediatric Hematology/Oncology
Volume35
Issue number3
DOIs
StatePublished - Apr 1 2013

Keywords

  • Febrile neutropenia
  • IL-8
  • Pediatric oncology
  • Risk prediction

ASJC Scopus subject areas

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

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