| Abstract [eng] |
Blood cancer and/or related intensive chemotherapy may cause decreased host defense against infection. One of the key factors of infections process is treatment related neutropenia that is accompanied by fever. Patient with chemotherapy – related neutropenia and fever are usually hospitalized and treated on empirical intravenous broad – spectrum antibiotic regimen. Early diagnosis of sepsis in children with febrile neutropenia remains difficult due to non – specific clinical and labaratory signs of infection. Therefore it is very important in clinical practice have a sensitive and specific immunological marker, which helps children with febrile neutropenia attributed to the low risk of infectious disease, thereby avoiding unnecessary use of antibiotics and long – term hospitalization. The objective was to evaluate the process of infection and immune response driven markers ( cytokines,acute phase proteins) changes in the early infections process in order to identify children with low – infection risk group, suffering from oncohematological diseases. The target group consists of fourtyfive oncohematology patient with febrile neutropenia which were treated in Vilniaus University hospital of chidren, from 2009 – 2010. Were analyzed the sixtysix epizodes of febrile neutropenia. According to clinical and microbiological parameters were divided into low risk and high risk groups. Low – risk group included patients with fabrile episodes, a negatyve blood culture and the absence of clinically documented infections ( n= 27; 60%). High – risk group consisted of patients with positive blood cultures and clinically documented sepsis(n= 18, and 40%). The results is that the most sensitive( 94.6%) low risk of infection prognosis (AUC – 0,774) consist of an absoliute number of monocytes, which threshold value is >0,003 x10⁹l. Cytokines IL – 8 may be seen as a very specific infection group markers. PCT is a predisposing factor for bacterial infection. CRP is not sufficiently sensitive indicators to measyre the low infection risk group ( sensitivity, 72,4%, specifity – 45,9%). |
