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Abstract
treatment-related neutropenia following antineoplastic chemotherapy is associated with a high risk of infections. Prediction of deteriorating or a stable course during the febrile episode is ambiguous. It has therefore been recommended to reassess anti-microbial therapy from fever 3–5 days onward.
In the majority of neutropenic fever episodes, causative infectious agents cannot be identified. A specific, rapid and cost-effective marker indicating ongoing infection or indicating deterioration during the febrile neutropenic period would therefore be highly warranted, especially that the infected neutropenic patients are capable of producing high plasma and serum levels of pro-inflammatory cytokines as Interleukin-6 (IL-6) and C-reactive protein (CRP).
Safe application of risk-adapted treatment in clinical practice is only possible if we are able to safely discriminate low- and high-risk patients for bacterial infection. Low-risk patients may be treated with oral antibiotics and be discharged from the hospital earlier or not be hospitalized. On the other hand, high-risk patients require close follow-up for early diagnosis and prophylactic use of antibiotic therapy and colony stimulating factors and need longer hospitalization. That a risk assessment model using clinical features in combination with serum cytokine levels can select low-risk patients appropriately.
In this study, we evaluated Interleukin-6 and C reactive protein as inflammatory markers in identification of the clinical course of febrile neutropenia in hematological malignancies aiming to evaluate their clinical significance, for this,30 febrile neutropenic episodes in 23 patients with different types of hematological malignancies, monitored clinically and laboratory and serum level of IL-6 and quantitative determination of CRP were measured in the non febrile neutropenic period, the first day, the second day and in the third day of fever.