A predictor of unfavourable outcome in neutropenic paediatric patients presenting with fever of unknown origin

Pediatric Blood & Cancer
Michaela SemeraroOlivier Hartmann

Abstract

No sensitive, specific marker able to discriminate favourable or unfavourable outcome of fever of unknown origin (FUO) at diagnosis has been identified. Procalcitonin, a recently assessed infection marker, may be useful in predicting the outcome of FUO. We conducted a prospective study examining the following variables: age 0.5-22 years; solid tumour diagnosis; chemotherapy-related grade-4 febrile neutropenia (FN). A complete clinical, bacteriological and biological evaluation was performed at hospital admission (H0). Other investigations depended on clinical status. FUO was considered to be of unfavourable outcome if the fever was persistent or re-appeared at day 3 (or later), or if secondary clinical or microbiological infection occurred. To validate the results of the analysis the data set was randomly split into a training set and a validation set. Out of 172 episodes of FN, 136 episodes were classified as FUO (80%). Seventy-two (53%) were included in this study. PCT values were significantly higher in episodes of unfavourable outcome (P < 0.001). None of the other prediction candidates appeared to be significantly linked to the risk of unfavourable outcome. In the validation set, the best PCT cut-off was 0.12 micro/L, whic...Continue Reading

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Citations

Feb 24, 2015·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Chun-Wei WuChien-Chang Lee
Mar 8, 2012·Current Opinion in Infectious Diseases·Roland A AmmannBob Phillips
Aug 14, 2015·Pediatric Hematology and Oncology·Metin DemirkayaOzlem Balci Ekmekci
Nov 1, 2011·Current Opinion in Pediatrics·Oliver Teuffel, Lillian Sung
Apr 29, 2010·American Journal of Hematology·Loredana SarmatiMassimo Andreoni
Jun 4, 2010·Current Opinion in Oncology·María E Santolaya
Feb 22, 2012·Bone Marrow Transplantation·J KoyaM Kurokawa

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