IL-10 combined with procalcitonin improves early prediction of complications of febrile neutropenia in hematological patients
► IL-10 is an early predictor of complicated course of febrile neutropenia. ► Procalcitonin stays elevated for several days in complicated febrile neutropenia. ► Levels of IL-6 and IL-10 normalize more rapidly than that of procalcitonin. ► IL-10 combined with procalcitonin improves early prediction...
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| Veröffentlicht in: | Cytokine (Philadelphia, Pa.) Pa.), 2012-12, Vol.60 (3), p.787-792 |
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| creator | Vänskä, Matti Koivula, Irma Jantunen, Esa Hämäläinen, Sari Purhonen, Anna-Kaisa Pulkki, Kari Juutilainen, Auni |
| description | ► IL-10 is an early predictor of complicated course of febrile neutropenia. ► Procalcitonin stays elevated for several days in complicated febrile neutropenia. ► Levels of IL-6 and IL-10 normalize more rapidly than that of procalcitonin. ► IL-10 combined with procalcitonin improves early prediction of complications.
Early diagnosis of complicated course in febrile neutropenia is cumbersome due to the non-specificity of clinical and laboratory signs of severe infection. This prospective study included 100 adult hematological patients with febrile neutropenia after intensive chemotherapy at the onset of fever (d0) and for 3days (d1–d3) thereafter. The study aim was to find early predictors for complicated course of febrile neutropenia, defined as bacteremia or septic shock. Interleukin 6 (IL-6), interleukin 10 (IL-10), procalcitonin (PCT) and C-reactive protein (CRP) all predicted complicated course of febrile neutropenia on d0, but only PCT was predictive throughout the study period. For IL-10 on d0–1 with cut-off 37ng/L, sensitivity was 0.71, specificity 0.82, positive predictive value 0.52 and negative predictive value 0.92. For PCT on d0–1 with cut-off 0.13μg/L, the respective measures were 0.95, 0.53, 0.36, and 0.98. For the combination of IL-10 and PCT on d0–1 with the same cut-offs, specificity improved to 0.85 and positive predictive value to 0.56. In conclusion, the present study confirms the high negative predictive value of PCT and provides new evidence for IL-10 as an early predictor for complicated course of febrile neutropenia in hematological patients. Combining IL-10 with PCT improves the early prediction for complicated course of febrile neutropenia. |
| doi_str_mv | 10.1016/j.cyto.2012.07.023 |
| format | Article |
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Early diagnosis of complicated course in febrile neutropenia is cumbersome due to the non-specificity of clinical and laboratory signs of severe infection. This prospective study included 100 adult hematological patients with febrile neutropenia after intensive chemotherapy at the onset of fever (d0) and for 3days (d1–d3) thereafter. The study aim was to find early predictors for complicated course of febrile neutropenia, defined as bacteremia or septic shock. Interleukin 6 (IL-6), interleukin 10 (IL-10), procalcitonin (PCT) and C-reactive protein (CRP) all predicted complicated course of febrile neutropenia on d0, but only PCT was predictive throughout the study period. For IL-10 on d0–1 with cut-off 37ng/L, sensitivity was 0.71, specificity 0.82, positive predictive value 0.52 and negative predictive value 0.92. For PCT on d0–1 with cut-off 0.13μg/L, the respective measures were 0.95, 0.53, 0.36, and 0.98. For the combination of IL-10 and PCT on d0–1 with the same cut-offs, specificity improved to 0.85 and positive predictive value to 0.56. In conclusion, the present study confirms the high negative predictive value of PCT and provides new evidence for IL-10 as an early predictor for complicated course of febrile neutropenia in hematological patients. Combining IL-10 with PCT improves the early prediction for complicated course of febrile neutropenia.</description><identifier>ISSN: 1043-4666</identifier><identifier>EISSN: 1096-0023</identifier><identifier>DOI: 10.1016/j.cyto.2012.07.023</identifier><identifier>PMID: 22902948</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adolescent ; Adult ; Aged ; Bacteremia ; Bacteremia - diagnosis ; C-reactive protein ; C-Reactive Protein - analysis ; Calcitonin - blood ; Calcitonin - metabolism ; Calcitonin Gene-Related Peptide ; Chemotherapy ; Female ; Fever ; Fever - etiology ; Humans ; Infection ; Interleukin 10 ; Interleukin 6 ; Interleukin-10 - blood ; Interleukin-10 - metabolism ; Interleukin-6 - blood ; Interleukin-6 - metabolism ; Leukemia, Myeloid, Acute - therapy ; Male ; Middle Aged ; Neutropenia ; Neutropenia - complications ; Neutropenia - diagnosis ; Neutropenic fever ; Procalcitonin ; Prognosis ; Prospective Studies ; Protein Precursors - blood ; Protein Precursors - metabolism ; Septic shock ; Shock, Septic - diagnosis ; Stem Cell Transplantation ; Transplantation, Autologous ; Young Adult</subject><ispartof>Cytokine (Philadelphia, Pa.), 2012-12, Vol.60 (3), p.787-792</ispartof><rights>2012 Elsevier Ltd</rights><rights>Copyright © 2012 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c389t-514fba021d532b5fa6998f17572e107afb523be8cd650971d0073ed53dea7ebb3</citedby><cites>FETCH-LOGICAL-c389t-514fba021d532b5fa6998f17572e107afb523be8cd650971d0073ed53dea7ebb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.cyto.2012.07.023$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,778,782,3539,27907,27908,45978</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22902948$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vänskä, Matti</creatorcontrib><creatorcontrib>Koivula, Irma</creatorcontrib><creatorcontrib>Jantunen, Esa</creatorcontrib><creatorcontrib>Hämäläinen, Sari</creatorcontrib><creatorcontrib>Purhonen, Anna-Kaisa</creatorcontrib><creatorcontrib>Pulkki, Kari</creatorcontrib><creatorcontrib>Juutilainen, Auni</creatorcontrib><title>IL-10 combined with procalcitonin improves early prediction of complications of febrile neutropenia in hematological patients</title><title>Cytokine (Philadelphia, Pa.)</title><addtitle>Cytokine</addtitle><description>► IL-10 is an early predictor of complicated course of febrile neutropenia. ► Procalcitonin stays elevated for several days in complicated febrile neutropenia. ► Levels of IL-6 and IL-10 normalize more rapidly than that of procalcitonin. ► IL-10 combined with procalcitonin improves early prediction of complications.
Early diagnosis of complicated course in febrile neutropenia is cumbersome due to the non-specificity of clinical and laboratory signs of severe infection. This prospective study included 100 adult hematological patients with febrile neutropenia after intensive chemotherapy at the onset of fever (d0) and for 3days (d1–d3) thereafter. The study aim was to find early predictors for complicated course of febrile neutropenia, defined as bacteremia or septic shock. Interleukin 6 (IL-6), interleukin 10 (IL-10), procalcitonin (PCT) and C-reactive protein (CRP) all predicted complicated course of febrile neutropenia on d0, but only PCT was predictive throughout the study period. For IL-10 on d0–1 with cut-off 37ng/L, sensitivity was 0.71, specificity 0.82, positive predictive value 0.52 and negative predictive value 0.92. For PCT on d0–1 with cut-off 0.13μg/L, the respective measures were 0.95, 0.53, 0.36, and 0.98. For the combination of IL-10 and PCT on d0–1 with the same cut-offs, specificity improved to 0.85 and positive predictive value to 0.56. In conclusion, the present study confirms the high negative predictive value of PCT and provides new evidence for IL-10 as an early predictor for complicated course of febrile neutropenia in hematological patients. Combining IL-10 with PCT improves the early prediction for complicated course of febrile neutropenia.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Bacteremia</subject><subject>Bacteremia - diagnosis</subject><subject>C-reactive protein</subject><subject>C-Reactive Protein - analysis</subject><subject>Calcitonin - blood</subject><subject>Calcitonin - metabolism</subject><subject>Calcitonin Gene-Related Peptide</subject><subject>Chemotherapy</subject><subject>Female</subject><subject>Fever</subject><subject>Fever - etiology</subject><subject>Humans</subject><subject>Infection</subject><subject>Interleukin 10</subject><subject>Interleukin 6</subject><subject>Interleukin-10 - blood</subject><subject>Interleukin-10 - metabolism</subject><subject>Interleukin-6 - blood</subject><subject>Interleukin-6 - metabolism</subject><subject>Leukemia, Myeloid, Acute - therapy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neutropenia</subject><subject>Neutropenia - complications</subject><subject>Neutropenia - diagnosis</subject><subject>Neutropenic fever</subject><subject>Procalcitonin</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Protein Precursors - blood</subject><subject>Protein Precursors - metabolism</subject><subject>Septic shock</subject><subject>Shock, Septic - diagnosis</subject><subject>Stem Cell Transplantation</subject><subject>Transplantation, Autologous</subject><subject>Young Adult</subject><issn>1043-4666</issn><issn>1096-0023</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUGP1SAUhYlx4oxP_4ALw9JN6wXa0iZuzGQcJ3mJG2dNgN46vNBSgTfmLfzv0rwZlxoWcOE7J-EcQt4xqBmw7uOhtqccag6M1yBr4OIFuWIwdBWU88vt3Iiq6brukrxO6QAAg5DyFbnkfAA-NP0V-X23rxhQG2bjFhzpL5cf6BqD1d66HBa3UDeX-RETRR39qTzi6Gx2YaFh2oSrd1Zvc9ouJjTReaQLHnMMKy5O02LygLPOwYcfhfV0LTwuOb0hF5P2Cd8-7Tty_-Xm-_XXav_t9u76876yoh9y1bJmMho4G1vBTTvpbhj6iclWcmQg9WRaLgz2duxaGCQbAaTAAo-oJRojduTD2bf85OcRU1azSxa91wuGY1KMy7IEl_3_UcZ5x2VTEt4RfkZtDClFnNQa3azjSTFQW0PqoLaG1NaQAqmKpojeP_kfzYzjX8lzJQX4dAawBPLoMKpkS1i2pB7RZjUG9y__P_R8pEE</recordid><startdate>201212</startdate><enddate>201212</enddate><creator>Vänskä, Matti</creator><creator>Koivula, Irma</creator><creator>Jantunen, Esa</creator><creator>Hämäläinen, Sari</creator><creator>Purhonen, Anna-Kaisa</creator><creator>Pulkki, Kari</creator><creator>Juutilainen, Auni</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7T5</scope><scope>H94</scope></search><sort><creationdate>201212</creationdate><title>IL-10 combined with procalcitonin improves early prediction of complications of febrile neutropenia in hematological patients</title><author>Vänskä, Matti ; Koivula, Irma ; Jantunen, Esa ; Hämäläinen, Sari ; Purhonen, Anna-Kaisa ; Pulkki, Kari ; Juutilainen, Auni</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c389t-514fba021d532b5fa6998f17572e107afb523be8cd650971d0073ed53dea7ebb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Bacteremia</topic><topic>Bacteremia - diagnosis</topic><topic>C-reactive protein</topic><topic>C-Reactive Protein - analysis</topic><topic>Calcitonin - blood</topic><topic>Calcitonin - metabolism</topic><topic>Calcitonin Gene-Related Peptide</topic><topic>Chemotherapy</topic><topic>Female</topic><topic>Fever</topic><topic>Fever - etiology</topic><topic>Humans</topic><topic>Infection</topic><topic>Interleukin 10</topic><topic>Interleukin 6</topic><topic>Interleukin-10 - blood</topic><topic>Interleukin-10 - metabolism</topic><topic>Interleukin-6 - blood</topic><topic>Interleukin-6 - metabolism</topic><topic>Leukemia, Myeloid, Acute - therapy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neutropenia</topic><topic>Neutropenia - complications</topic><topic>Neutropenia - diagnosis</topic><topic>Neutropenic fever</topic><topic>Procalcitonin</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Protein Precursors - blood</topic><topic>Protein Precursors - metabolism</topic><topic>Septic shock</topic><topic>Shock, Septic - diagnosis</topic><topic>Stem Cell Transplantation</topic><topic>Transplantation, Autologous</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vänskä, Matti</creatorcontrib><creatorcontrib>Koivula, Irma</creatorcontrib><creatorcontrib>Jantunen, Esa</creatorcontrib><creatorcontrib>Hämäläinen, Sari</creatorcontrib><creatorcontrib>Purhonen, Anna-Kaisa</creatorcontrib><creatorcontrib>Pulkki, Kari</creatorcontrib><creatorcontrib>Juutilainen, Auni</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>Cytokine (Philadelphia, Pa.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vänskä, Matti</au><au>Koivula, Irma</au><au>Jantunen, Esa</au><au>Hämäläinen, Sari</au><au>Purhonen, Anna-Kaisa</au><au>Pulkki, Kari</au><au>Juutilainen, Auni</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>IL-10 combined with procalcitonin improves early prediction of complications of febrile neutropenia in hematological patients</atitle><jtitle>Cytokine (Philadelphia, Pa.)</jtitle><addtitle>Cytokine</addtitle><date>2012-12</date><risdate>2012</risdate><volume>60</volume><issue>3</issue><spage>787</spage><epage>792</epage><pages>787-792</pages><issn>1043-4666</issn><eissn>1096-0023</eissn><abstract>► IL-10 is an early predictor of complicated course of febrile neutropenia. ► Procalcitonin stays elevated for several days in complicated febrile neutropenia. ► Levels of IL-6 and IL-10 normalize more rapidly than that of procalcitonin. ► IL-10 combined with procalcitonin improves early prediction of complications.
Early diagnosis of complicated course in febrile neutropenia is cumbersome due to the non-specificity of clinical and laboratory signs of severe infection. This prospective study included 100 adult hematological patients with febrile neutropenia after intensive chemotherapy at the onset of fever (d0) and for 3days (d1–d3) thereafter. The study aim was to find early predictors for complicated course of febrile neutropenia, defined as bacteremia or septic shock. Interleukin 6 (IL-6), interleukin 10 (IL-10), procalcitonin (PCT) and C-reactive protein (CRP) all predicted complicated course of febrile neutropenia on d0, but only PCT was predictive throughout the study period. For IL-10 on d0–1 with cut-off 37ng/L, sensitivity was 0.71, specificity 0.82, positive predictive value 0.52 and negative predictive value 0.92. For PCT on d0–1 with cut-off 0.13μg/L, the respective measures were 0.95, 0.53, 0.36, and 0.98. For the combination of IL-10 and PCT on d0–1 with the same cut-offs, specificity improved to 0.85 and positive predictive value to 0.56. In conclusion, the present study confirms the high negative predictive value of PCT and provides new evidence for IL-10 as an early predictor for complicated course of febrile neutropenia in hematological patients. Combining IL-10 with PCT improves the early prediction for complicated course of febrile neutropenia.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>22902948</pmid><doi>10.1016/j.cyto.2012.07.023</doi><tpages>6</tpages></addata></record> |
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| subjects | Adolescent Adult Aged Bacteremia Bacteremia - diagnosis C-reactive protein C-Reactive Protein - analysis Calcitonin - blood Calcitonin - metabolism Calcitonin Gene-Related Peptide Chemotherapy Female Fever Fever - etiology Humans Infection Interleukin 10 Interleukin 6 Interleukin-10 - blood Interleukin-10 - metabolism Interleukin-6 - blood Interleukin-6 - metabolism Leukemia, Myeloid, Acute - therapy Male Middle Aged Neutropenia Neutropenia - complications Neutropenia - diagnosis Neutropenic fever Procalcitonin Prognosis Prospective Studies Protein Precursors - blood Protein Precursors - metabolism Septic shock Shock, Septic - diagnosis Stem Cell Transplantation Transplantation, Autologous Young Adult |
| title | IL-10 combined with procalcitonin improves early prediction of complications of febrile neutropenia in hematological patients |
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