Deficiency of mannose-binding lectin-associated serine protease-2 associated with increased risk of fever and neutropenia in pediatric cancer patients

Schlapbach L.J., Aebi C., Otth M., Leibundgut K., Hirt A. and Ammann R.A. (2007) Deficiency of mannose-binding lectin-associated serine protease-2 associated with increased risk of fever and neutropenia in pediatric cancer patients. Pediatric Infectious Disease Journal, 26 11: 989-994. doi:10.1097/INF.0b013e31811ffe6a


Author Schlapbach L.J.
Aebi C.
Otth M.
Leibundgut K.
Hirt A.
Ammann R.A.
Title Deficiency of mannose-binding lectin-associated serine protease-2 associated with increased risk of fever and neutropenia in pediatric cancer patients
Journal name Pediatric Infectious Disease Journal   Check publisher's open access policy
ISSN 0891-3668
Publication date 2007-01-01
Year available 2007
Sub-type Article (original research)
DOI 10.1097/INF.0b013e31811ffe6a
Volume 26
Issue 11
Start page 989
End page 994
Total pages 6
Publisher LIPPINCOTT WILLIAMS & WILKINS
Language eng
Subject 2735 Pediatrics, Perinatology, and Child Health
2726 Microbiology (medical)
Abstract BACKGROUND: Mannose-binding lectin-associated serine protease-2 (MASP-2) is an essential component of the lectin pathway of complement activation. MASP-2 deficiency is common because of genetic polymorphisms, but its impact on susceptibility to infection is largely unknown. The aim of the present study was to determine whether children with cancer and MASP-2 deficiency develop more frequent or more severe episodes of fever and severe chemotherapy-induced neutropenia (FN). METHODS: Serum MASP-2 was measured by enzyme-linked immunosorbent assay at the time of diagnosis in children treated with chemotherapy for cancer. Association of FN episodes with MASP-2 concentration was analyzed using Poisson regression accounting for chemotherapy intensity and duration. RESULTS: Median MASP-2 in 94 children was 527 ng/mL (interquartile range, 367-686). Nine (10%) children had MASP-2 deficiency (<200 ng/mL). During a cumulative chemotherapy exposure time of 82 years, 177 FN episodes were recorded. MASP-2 deficient children had a significantly increased risk of developing FN (multivariate risk ratio, 2.08; 95% confidence interval, 1.31-3.21; P = 0.002), translating into significantly prolonged cumulative duration of hospitalization and of intravenous antimicrobial therapy. They experienced significantly more episodes of FN without a microbiologically defined etiology, and there was a trend toward more frequent episodes of FN with bacteremia. CONCLUSION: In this study, MASP-2 deficiency was associated with an increased risk of FN in children treated with chemotherapy for cancer. MASP-2 deficiency represents a novel risk factor for chemotherapy-related infections.
Keyword Bacteremia
Fever and neutropenia
Innate immunity
Mannose-binding lectin-associated serine protease-2 (MASP-2)
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collection: ResearcherID Downloads - Archived
 
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