Prognostic role of mid-regional pro-adrenomedullin in predicting infection in pediatric cancer with febrile neutropenia.
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BACKGROUND: Febrile neutropenia (FN) remains an important complication of cytotoxic chemotherapy for which an urgent and appropriate evaluation is imperative. PURPOSE: To assess the diagnostic and prognostic roles of mid-regional pro-adrenomedullin (MR-ProADM) levels in predicting infection in patients with FN. METHODS: This comparative cross-sectional study included 137 patients with chemotherapy-induced FN. Complete blood count, C-reactive protein (CRP), procalcitonin (PCT), and MR-ProADM were evaluated on the 1st day of FN. Chest computed tomography was performed on the 5th day. RESULTS: MR-ProADM levels were significantly higher in patients with FN than in controls. CRP and MR-ProADM levels were significantly higher and absolute neutrophil count (ANC) was significantly lower in patients with versus without bacterial infections. CRP, PCT, and MR-ProADM levels were significantly negatively correlated with ANC. CRP, PCT, and MR-ProADM levels were significantly and positively correlated with FN degree, FN duration, and hospital stay length. A multivariate regression analysis showed that a longer FN duration and hospital stay length, along with elevated CRP, PCT, and MR-ProADM levels, were significant risk factors for mortality. CONCLUSION: MR-ProADM is a reliable prognostic and diagnostic tool for predicting infection in patients with FN.