Abstract
Background. Infectious manifestations and sepsis are life-threatening complications in the course of the complex therapy in patients with cancer. The mortality rate can reach up to 30-50% if patients did not receive timely antibiotic treatment. However, infectious diseases and sepsis biomarkers can aid early diagnosis. Aim of the trial is to compare biomarkers for systemic inflammation (C-reactive protein, nitric oxide metabolites), infectious complications (procalcitonin, presepsin), antioxidant defense and oxidative damage (rate of reduced and oxidized forms of glutathione) and to evaluate prognostic value and applicability of these biomarkers in pediatric cancer diagnosis and treatment. Methods . 43 patients with cancer (aged ³18 years) were enrolled in this trial. Including criteria were signs of systemic inflammatory reaction (SIRS) or/and sepsis. In the first part of trial patients were divided in 2 groups according to the outcome of infectious complications or SIRS (Group I — alive, Group II — dead). Differences between groups were considered statistically significant at p<0.05. In the second part of trial we investigated ability of presepsin as a marker of sepsis in patients with leucopenia. Two groups were formed depending on white blood cells count: normal or below normal values. Results . Statistically significant differences were found between groups I and II in delta-value of presepsin (p=0 .020). This index for procalcitonin and C-reactive protein was not statistically significant (p=0.082 and p=0.432, respectively). There were no statistically significant differences in presepsin concentrations in patients with leucopenia and normal white blood cells count (p=0.469). Conclusion . A recent study revealed that only delta-value of presepsin significantly differs in groups with favorable and poor outcomes. There were no significant differences in concentration of presepsin in patients with leucopenia and normal white blood cells count.
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