SOLUBLE CD14 AS A BIOMARKER OF SEPSIS AND ITS RELATION TO BLOOD CULTURES IN FEBRILE NEUTROPENIC ACUTE MYELOID LEUKEMIA PATIENTS RECEIVING CHEMOTHERAPY

Abstract

• The incidence of acute leukemia in Egypt according to the National Population-Based Cancer Registry Program is about 3 cases per 100 000 population.• Acute leukemia is classified according to WHO classification which incorporates clinical, prognostic, morphologic, immunophenotypic, and genetic data.• Manifestations of acute leukemia can result from constitutional symptoms, bone marrow failure , infilteration of other organs and of leukocytosis.• Acute leukemia patients are more prone to infections due to several factors including neutropenia, disruption of mucosal barriers and administration of immune suppressive drugs. • The most popular tool used to predict the risk of complications associated with a febrile neutropenia is the Multinational Association of Supportive Care in Cancer (MASCC) score.• The use of standard culture techniques for the detection and isolation of pathogenic organisms from a sterile body fluid specimen is still considered the “gold standard” for the diagnosis of infection and sepsis.• Bacterial infections are commonly caused by six main etiologies: three Gram-negative (E. coli, Klebsiella sp and Pseudomonas aeruginosa) and three Gram-positive (S. aureus, S. epidermidis and S. Viridans). • Presepsin is a new sepsis marker that show a potential as an early marker of sepsis recognition, for antimi‌crobial therapy monitoring and as a prognostic marker. • Presepsin (sCD14-ST) is a peptide sized 13 kDa that is generated by proteolytic cleav‌age of soluble forms of CD14 cluster (sCD14). • The major CRP drawback in sepsis lies in its lack of specificity.