Novel biomarkers to identify complicated course of febrile neutropenia in hematological patients receiving intensive chemotherapy

IF 2.3 3区 医学 Q2 HEMATOLOGY European Journal of Haematology Pub Date : 2024-07-03 DOI:10.1111/ejh.14264
Esa Jantunen, Sari Hämäläinen, Kari Pulkki, Auni Juutilainen
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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.

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识别接受强化化疗的血液病患者发热性中性粒细胞减少症复杂病程的新型生物标志物。
发热性中性粒细胞减少症(FN)是血液病患者接受强化化疗的常见后果。90%以上的急性髓性白血病(AML)患者会出现发热性中性粒细胞减少症,其中5%-10%的患者会死于随后的败血症。FN在自体干细胞移植受者中也很常见,但死亡风险低于急性髓性白血病患者。在这篇综述中,我们将讨论用于诊断和预后FN血液病患者的生物标志物。一般来说,新型生物标志物与传统的炎症生物标志物(如 C 反应蛋白和降钙素原)相比,几乎没有什么益处。大多数生物标志物对 FN 血液病患者的效用仅在少数几项小型研究中进行了评估。尽管其中一些生物标志物看起来很有前景,但在对 FN 患者进行临床评估之前,还需要更多的数据。目前,密切随访患者是发现 FN 复杂病程和是否需要进一步干预(如入住重症监护室)的关键。q-SOFA(器官衰竭快速序列评估)或NEWS(国家预警信号)等评分系统与传统和/或新型生物标记物相结合,可为 FN 患者的临床评估提供附加价值。
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来源期刊
CiteScore
5.50
自引率
0.00%
发文量
168
审稿时长
4-8 weeks
期刊介绍: European Journal of Haematology is an international journal for communication of basic and clinical research in haematology. The journal welcomes manuscripts on molecular, cellular and clinical research on diseases of the blood, vascular and lymphatic tissue, and on basic molecular and cellular research related to normal development and function of the blood, vascular and lymphatic tissue. The journal also welcomes reviews on clinical haematology and basic research, case reports, and clinical pictures.
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