FNP SERUM MARKERS
Systematic review of prognostic serum markers in febrile neutropenic episodes in children and young people undergoing treatment for malignant disease
BackgroundThis systematic review aims to identify, critically appraise, and synthesise information on the use of serum markers for the prediction of the outcome of febrile neutropenic episodes in children/young adults.
The systematic review of the predictive value of serum markers of inflammation and infection in children presenting with febrile neutropenia included 27 studies reporting over 13 different markers from an initial screen of 375 studies. The studies included presented similar methodological challenges and had problems of reporting and analysis.
Many studies failed to assess if the marker had any supplementary value over and above the simple admission data collected by the clinicians at every encounter: age, malignancy, temperature, age-corrected vital statistics and blood count.
In order to interpret the information on serum markers in a clinically meaningful way, allowance for the marked heterogeneity in results must be made and conclusions reached only tentatively. The meaningful quantitative pooling and a qualitative summary of the results suggest that procalcitonin was a better discriminatory marker than C-reactive protein, and that interleukin 6 had a very good ability to predict documented infection. Data for the other markers were too sparse to reasonably interpret. These conclusions should be read with the understanding that these are uncertain and unstable, and only small amounts of new data may substantially alter the findings.Conducted by: CRD
Commissioned by the Medical Research Council