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 Citations (Scopus)

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 2013

Fingerprint

Febrile Neutropenia
Bacteremia
Interleukin-8
Pediatrics
Logistic Models
Cytokines
Virus Diseases
Respiratory Tract Infections
C-Reactive Protein
Medical Records
Cohort Studies
Prospective Studies
Serum

Keywords

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

ASJC Scopus subject areas

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

Cite this

IL-8 predicts pediatric oncology patients with febrile neutropenia at low risk for bacteremia. / Cost, Carrye R.; Stegner, Martha M.; Leonard, David; Leavey, Patrick.

In: Journal of Pediatric Hematology/Oncology, Vol. 35, No. 3, 04.2013, p. 206-211.

Research output: Contribution to journalArticle

@article{2055d03e0c5649ceaa09be0d90fb1e18,
title = "IL-8 predicts pediatric oncology patients with febrile neutropenia at low risk for bacteremia",
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.",
keywords = "Febrile neutropenia, IL-8, Pediatric oncology, Risk prediction",
author = "Cost, {Carrye R.} and Stegner, {Martha M.} and David Leonard and Patrick Leavey",
year = "2013",
month = "4",
doi = "10.1097/MPH.0b013e318281e653",
language = "English (US)",
volume = "35",
pages = "206--211",
journal = "Journal of Pediatric Hematology/Oncology",
issn = "1077-4114",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - IL-8 predicts pediatric oncology patients with febrile neutropenia at low risk for bacteremia

AU - Cost, Carrye R.

AU - Stegner, Martha M.

AU - Leonard, David

AU - Leavey, Patrick

PY - 2013/4

Y1 - 2013/4

N2 - 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.

AB - 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.

KW - Febrile neutropenia

KW - IL-8

KW - Pediatric oncology

KW - Risk prediction

UR - http://www.scopus.com/inward/record.url?scp=84876114236&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84876114236&partnerID=8YFLogxK

U2 - 10.1097/MPH.0b013e318281e653

DO - 10.1097/MPH.0b013e318281e653

M3 - Article

C2 - 23425997

AN - SCOPUS:84876114236

VL - 35

SP - 206

EP - 211

JO - Journal of Pediatric Hematology/Oncology

JF - Journal of Pediatric Hematology/Oncology

SN - 1077-4114

IS - 3

ER -