Abstract:
Febrile neutropenia (FN) is a common consequence of intensive chemotherapy in hematological patients. More than 90% of the patients with acute myeloid leukemia (AML) develop FN, and 5%-10% of them die from subsequent sepsis. FN is very common also in autologous stem cell transplant recipients, but the risk of death is lower than in AML patients. In this review, we discuss biomarkers that have been evaluated for diagnostic and prognostic purposes in hematological patients with FN. In general, novel biomarkers have provided little benefit over traditional inflammatory biomarkers, such as C-reactive protein and procalcitonin. The utility of most biomarkers in hematological patients with FN has been evaluated in only a few small studies. Although some of them appear promising, much more data is needed before they can be implemented in the clinical evaluation of FN patients. Currently, close patient follow-up is key to detect complicated course of FN and the need for further interventions such as intensive care unit admission. Scoring systems such as q-SOFA (Quick Sequential Organ Failure Assessment) or NEWS (National Early Warning Sign) combined with traditional and/or novel biomarkers may provide added value in the clinical evaluation of FN patients.
摘要:
发热性中性粒细胞减少症(FN)是血液患者强化化疗的常见后果。超过90%的急性髓系白血病(AML)患者发展为FN,其中5%-10%死于随后的败血症。FN在自体干细胞移植受体中也很常见,但死亡风险低于AML患者。在这次审查中,我们讨论了已评估用于诊断和预后目的的血液FN患者的生物标志物。总的来说,与传统的炎症生物标志物相比,新型生物标志物几乎没有益处,如C反应蛋白和降钙素原。仅在少数小型研究中评估了大多数生物标志物在FN血液学患者中的实用性。尽管其中一些看起来很有希望,在对FN患者进行临床评估之前,还需要更多的数据.目前,密切患者随访是发现复杂FN病程以及需要进一步干预措施如重症监护病房的关键.评分系统,如q-SOFA(快速序贯器官衰竭评估)或NEWS(国家早期预警标志),结合传统和/或新型生物标志物,可以在FN患者的临床评估中提供附加值。