Presepsin and Midregional Proadrenomedullin in Pediatric Oncologic Patients with Febrile Neutropenia

Lab Med. 2020 Nov 2;51(6):585-591. doi: 10.1093/labmed/lmaa011.

Abstract

Objective: In this study, we investigated the roles of presepsin (PSP) and midregional proadrenomedullin (mr-proADM) in children with febrile neutropenia (FN) due to chemotherapy.

Methods: We assessed 36 FN episodes in 26 children. Patients were classified into bacteremia (B) and fever of unknown origin (FUO) groups. We evaluated PSP and mr-proADM at admission (T0), after 24/48 h (T1), and after 5 days (T2).

Results: PSP and mr-proADM levels were elevated at T0 and significantly decreased at T2. mr-proADM levels did not significantly differ between the B and FUO groups. PSP levels significantly differed between the B and FUO groups only at T1. Both PSP and mr-proADM levels at T0 were a predictor of length of hospital stay but not of the duration of fever. Finally, receiver operating characteristic curve analysis showed that PSP and mr-proADM had low diagnostic accuracy for blood culture positivity.

Conclusion: PSP and mr-proADM display poor clinical usefulness for FN in oncologic children.

Keywords: Adrenomedullin; Presepsin; fever; malignancies; mr-proADM; neutropenia; oncologic; pediatric.

MeSH terms

  • Adrenomedullin / blood*
  • Age Factors
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biomarkers*
  • Child
  • Febrile Neutropenia / blood*
  • Febrile Neutropenia / diagnosis
  • Febrile Neutropenia / etiology
  • Female
  • Humans
  • Lipopolysaccharide Receptors / blood*
  • Male
  • Neoplasms / blood*
  • Neoplasms / complications
  • Neoplasms / diagnosis
  • Neoplasms / drug therapy
  • Peptide Fragments / blood*
  • Prognosis
  • Protein Precursors / blood*
  • ROC Curve

Substances

  • Biomarkers
  • Lipopolysaccharide Receptors
  • Peptide Fragments
  • Protein Precursors
  • presepsin protein, human
  • proadrenomedullin
  • Adrenomedullin