BACKGROUND: Fever in neutropenia (FN) is a frequent complication in pediatric oncology. Deficiency of mannose-binding lectin (MBL), an important component of innate immunity, is common due to genetic polymorphisms, but its impact on infections in oncologic patients is controversial. This study investigated whether MBL serum levels at cancer diagnosis are associated with the development of FN in pediatric cancer patients. PROCEDURE: Serum MBL was measured using ELISA. Frequency, duration, and cause of FN were assessed retrospectively. Association with MBL level was analyzed using uni- and multivariate Poisson regression taking into account both intensity and duration of chemotherapy. RESULTS: In 94 children, with a cumulative follow-up time of 81.7 years, 177 FN episodes were recorded. Patients with both very low MBL levels (<100 microg/L; risk ratio (RR), 1.93; 95% CI, 1.14-3.28; P = 0.014) and normal MBL levels (>or=1,000 microg/L; RR, P = 0.011) had significantly more frequent FN episodes than patients with low MBL levels (100-999 microg/L). Patients with very low MBL levels had significantly more episodes of FN with severe bacterial infection (bacteremia or pneumonia; RR, 4.49; 1.69 = 11.8; P = 0.003), while those with normal MBL levels had more FN episodes with no microbial etiology identified (RR, 1.85; 1.14 = 3.03; P = 0.014). CONCLUSIONS: Very low MBL levels are associated with more frequent FN episodes, mainly due to severe bacterial infections. The surprising finding that children with normal MBL levels had more frequent FN episodes than those with low MBL levels needs testing in prospective studies.
BACKGROUND:Fever in neutropenia (FN) is a frequent complication in pediatric oncology. Deficiency of mannose-binding lectin (MBL), an important component of innate immunity, is common due to genetic polymorphisms, but its impact on infections in oncologic patients is controversial. This study investigated whether MBL serum levels at cancer diagnosis are associated with the development of FN in pediatric cancerpatients. PROCEDURE: Serum MBL was measured using ELISA. Frequency, duration, and cause of FN were assessed retrospectively. Association with MBL level was analyzed using uni- and multivariate Poisson regression taking into account both intensity and duration of chemotherapy. RESULTS: In 94 children, with a cumulative follow-up time of 81.7 years, 177 FN episodes were recorded. Patients with both very low MBL levels (<100 microg/L; risk ratio (RR), 1.93; 95% CI, 1.14-3.28; P = 0.014) and normal MBL levels (>or=1,000 microg/L; RR, P = 0.011) had significantly more frequent FN episodes than patients with low MBL levels (100-999 microg/L). Patients with very low MBL levels had significantly more episodes of FN with severe bacterial infection (bacteremia or pneumonia; RR, 4.49; 1.69 = 11.8; P = 0.003), while those with normal MBL levels had more FN episodes with no microbial etiology identified (RR, 1.85; 1.14 = 3.03; P = 0.014). CONCLUSIONS: Very low MBL levels are associated with more frequent FN episodes, mainly due to severe bacterial infections. The surprising finding that children with normal MBL levels had more frequent FN episodes than those with low MBL levels needs testing in prospective studies.
Authors: F N J Frakking; N Brouwer; K M Dolman; J B M van Woensel; H N Caron; T W Kuijpers; M D van de Wetering Journal: Clin Exp Immunol Date: 2011-04-13 Impact factor: 4.330
Authors: J M Kwakkel-van Erp; A W M Paantjens; D A van Kessel; J C Grutters; J M M van den Bosch; E A van de Graaf; H G Otten Journal: Clin Exp Immunol Date: 2011-06-27 Impact factor: 4.330
Authors: Jessica M van der Bol; Floris A de Jong; Ron H van Schaik; Alex Sparreboom; Marianne A van Fessem; Fleur E van de Geijn; Paul L van Daele; Jaap Verweij; Stefan Sleijfer; Ron H Mathijssen Journal: Oncologist Date: 2010-10-07
Authors: O W Neth; U Bacher; P Das; T Zabelina; H Kabisch; N Kroeger; F Ayuk; M Lioznov; O Waschke; B Fehse; R Thiébaut; R M Haston; N Klein; A R Zander Journal: Bone Marrow Transplant Date: 2009-05-11 Impact factor: 5.483
Authors: Sharon R Pine; Leah E Mechanic; Stefan Ambs; Elise D Bowman; Stephen J Chanock; Christopher Loffredo; Peter G Shields; Curtis C Harris Journal: J Natl Cancer Inst Date: 2007-09-11 Impact factor: 13.506
Authors: Annina N von Allmen; Maxime G Zermatten; Kurt Leibundgut; Philipp Agyeman; Roland A Ammann Journal: Sci Data Date: 2018-03-13 Impact factor: 6.444