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

Schlapbach, L. J., Aebi, C., Otth, M., Luethy, A. Ridolfi, Leibundgut K., Hirt A. and Ammann R.A. (2007) Serum levels of mannose-binding lectin and the risk of fever in neutropenic pediatric cancer patients. Pediatric Blood and Cancer, 49 1: 11-16. doi:10.1002/pbc.21097


Author Schlapbach, L. J.
Aebi, C.
Otth, M.
Luethy, A. Ridolfi
Leibundgut K.
Hirt A.
Ammann R.A.
Title Serum levels of mannose-binding lectin and the risk of fever in neutropenic pediatric cancer patients
Journal name Pediatric Blood and Cancer   Check publisher's open access policy
ISSN 1545-5009
1545-5017
Publication date 2007-07-01
Year available 2006
Sub-type Article (original research)
DOI 10.1002/pbc.21097
Open Access Status Not yet assessed
Volume 49
Issue 1
Start page 11
End page 16
Total pages 6
Place of publication Hoboken, NJ, United States
Publisher John Wiley & Sons
Language eng
Formatted abstract
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 μg/L; risk ratio (RR), 1.93; 95% Cl, 1.14-3.28; P = 0.014) and normal MBL levels (≥1,000 μg/L; RR, 1.64; 1.12-2.40; P = 0.011) had significantly more frequent FN episodes than patients with low MBL levels (100-999 μg/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.
Keyword Chemotherapy
Children
Fever in neutropenia
Infection
Innate immunity
Mannose-binding lectin
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: Mater Research Institute-UQ (MRI-UQ)
 
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