Serum levels of mannose-binding lectin and the risk of fever in neutropenia pediatric cancer patients

Schlapbach, L J; Aebi, C; Otth, M; Luethy, A Ridolfi; Leibundgut, K; Hirt, A; Ammann, R A (2006). Serum levels of mannose-binding lectin and the risk of fever in neutropenia pediatric cancer patients. Pediatric blood & cancer, 49(1), pp. 11-16. Hoboken, N.J.: Wiley-Liss 10.1002/pbc.21097

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BACKGROUND: Fever in neutropenia (FN) is a frequent complication in pediatric oncology. Deficiency of mannose-binding lectin (MBL), an important component of innate immunity, is common due to genetic polymorphisms, but its impact on infections in oncologic patients is controversial. This study investigated whether MBL serum levels at cancer diagnosis are associated with the development of FN in pediatric cancer patients. PROCEDURE: Serum MBL was measured using ELISA. Frequency, duration, and cause of FN were assessed retrospectively. Association with MBL level was analyzed using uni- and multivariate Poisson regression taking into account both intensity and duration of chemotherapy. RESULTS: In 94 children, with a cumulative follow-up time of 81.7 years, 177 FN episodes were recorded. Patients with both very low MBL levels (<100 microg/L; risk ratio (RR), 1.93; 95% CI, 1.14-3.28; P = 0.014) and normal MBL levels (>/=1,000 microg/L; RR, P = 0.011) had significantly more frequent FN episodes than patients with low MBL levels (100-999 microg/L). Patients with very low MBL levels had significantly more episodes of FN with severe bacterial infection (bacteremia or pneumonia; RR, 4.49; 1.69 = 11.8; P = 0.003), while those with normal MBL levels had more FN episodes with no microbial etiology identified (RR, 1.85; 1.14 = 3.03; P = 0.014). CONCLUSIONS: Very low MBL levels are associated with more frequent FN episodes, mainly due to severe bacterial infections. The surprising finding that children with normal MBL levels had more frequent FN episodes than those with low MBL levels needs testing in prospective studies. Pediatr Blood Cancer (c) 2006 Wiley-Liss, Inc.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine
UniBE Contributor:	Schlapbach, Luregn Jan, Aebi, Christoph, Leibundgut, Kurt, Hirt, Andreas, Ammann, Roland
ISSN:	1545-5009
ISBN:	17143875
Publisher:	Wiley-Liss
Language:	English
Submitter:	Anette van Dorland
Date Deposited:	04 Oct 2013 14:48
Last Modified:	05 Dec 2022 14:14
Publisher DOI:	10.1002/pbc.21097
PubMed ID:	17143875
Web of Science ID:	000246787100004
URI:	https://boris.unibe.ch/id/eprint/19981 (FactScience: 3060)