Diagnostic Role of sCD14-Subtype as a Sepsis Biomarker in Febrile Neutropenic Pediatric Oncology Patients

Abstract

Introduction and Objective: Febrile neutropenia (FN) is one of the most common complications of cancer chemotherapyand requires urgent treatment. Upon diagnosis of childhood FN, culture samples should be obtained and a broad spectrumantibiotherapy should be administered immediately. However, bacterial infections are not the only cause of fever in neutropenicpediatric patients; chemotherapeutics, the disease itself, as well as viral and fungal agents can also be the cause of fever. Variousbiomarkers have been studied to differentiate the cause of fever to date. Infections are mostly lethal in neutropenic patients,early stage differential biomarkers are, therefore, of utmost importance. It is the aim of this study to assess the potential ofpresepsin as an additional diagnostic tool for the detection of bacteremia/sepsis in childhood Febrile Neutropenia (FN) patients.Methods: Twenty-four pediatric patients, with a total 29 febrile neutropenic episodes were enrolled in this study. One patientwith 3 FN episodes, three patients with 2 FN episodes were admitted to our clinic during the study. Patients were classified intobacteremia/sepsis and fever without origin groups. Serum samples were collected after confirmation of FN and analyzed forpresepsin, c-reactive protein (CRP) and procalcitonin (PCT) according to instructions of manufacturers.Results: Biomarkers failed to display a discriminative value between bacteremia/sepsis and fever without origin groups,whereas presepsin was found to be an indicator of the presence of bacterial growth in hemoculture and was shown to have apotential diagnostic value.Conclusion: Presepsin might be used as an additional diagnostic tool for the detection of bacteremia/sepsis in childhood FNpatients.