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Prediction of outcome in cancer patients with febrile neutropenia: comparison of the Multinational Association of Supportive Care in Cancer risk-index score with procalcitonin, C-reactive protein, serum amyloid A, and interleukins-1β, -6, -8 and -10

Authors

  • A. UYS phd, clinical trial coordinator,

    Corresponding author
    1. The Medical Oncology Centre of Rosebank, Johannesburg,
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  • B.L. RAPOPORT md, mmed, director and physician in charge,

    1. The Medical Oncology Centre of Rosebank, Johannesburg,
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  • H. FICKL msc, senior medical scientist,

    1. Medical Research Council Unit for Inflammation and Immunity, Department of Immunology, Faculty of Health Sciences, University of Pretoria and Tshwane Academic, Division of the National Health Laboratory Services, Pretoria, South Africa
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  • P.W.A. MEYER mtech, laboratory manager,

    1. Medical Research Council Unit for Inflammation and Immunity, Department of Immunology, Faculty of Health Sciences, University of Pretoria and Tshwane Academic, Division of the National Health Laboratory Services, Pretoria, South Africa
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  • R. ANDERSON phd, head of department

    1. Medical Research Council Unit for Inflammation and Immunity, Department of Immunology, Faculty of Health Sciences, University of Pretoria and Tshwane Academic, Division of the National Health Laboratory Services, Pretoria, South Africa
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Almarie Uys, The Medical Oncology Centre of Rosebank, Johannesburg, South Africa (e-mail: almarie@info-sa.co.za).

Abstract

The primary objective of the study was to compare the predictive potential of procalcitonin (PCT), C-reactive protein (CRP), serum amyloid A (SAA), and interleukin (IL)-1β, IL-6, IL-8, and IL-10, with that of the Multinational Association of Supportive Care in Cancer (MASCC) risk-index score in cancer patients on presentation with chemotherapy-induced febrile neutropenia (FN). Seventy-eight consecutive FN episodes in 63 patients were included, and MASCC scores, as well as concentrations of CRP, SAA, PCT, and IL-1β, IL-6, IL-8 and IL-10, and haematological parameters were determined on presentation, 72 h later and at outcome. Multivariate analysis of data revealed the MASCC score, but none of the laboratory parameters, to be an accurate, independent variable (P < 0.0001) for prediction of resolution with or without complications and death. Of the various laboratory parameters, PCT had the strongest association with the MASCC score (r = −0.51; P < 0.0001). In cancer patients who present with FN, the MASCC risk-index score is a useful predictor of outcome, while measurement of PCT, CRP, SAA, or IL-1β, IL-6, IL-8 and IL-10, is of limited value.

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