Abstract
The aim of this paper was to evaluate the usefulness of C-Reactive Protein (CRP), Procalcitonin (PCT) and Interleukine 6 (IL6) biomarkers in predicting the existence of Gram negative bloodstream infections (Gr-BSI) or the development of Systemic Inflammatory Response Syndrome (SIRS) during the first 24 hours of fever in pediatric cancer patients. The present study included a total of 103 consecutive fever episodes in 44 hemato-oncological pediatric patients, from whom samples for biomarkers CRP, PCT and IL6 were taken upon initial evaluation and then between 12 and 24 hours after.An IL6 value at the first evaluation (IL6-1) higher than 164 pg/ml and an increase in CRP higher than 291% between the first and subsequent samples (CRP-2vs1) showed a statistically significant OR of 26.03 and 19.62, respectively, in multivariate analysis.Conclusion: IL6-1 and CRP-2vs1 showed a strong, independent correlation with Gr-BSI and SIRS episodes and, therefore, could be used as reliable predictors of these kinds of severe episodes. The approach taken in our study, using biomarker variations over time as a variable, has shown itself to be an improvement in the predictive model.