Prognostic role of midregional proadrenomedullin in predicting infection in pediatric cancer with febrile neutropenia.

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, and MR-ProADM were evaluated on the 1st day of FN. Chest computed tomography (CT) 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 ANC was significantly lower in patients with versus without bacterial infections. CRP, procalcitonin, and MR-ProADM levels were significantly negatively correlated with absolute neutrophil count (ANC). CRP, procalcitonin, 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, procalcitonin, 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.