{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:10:13Z","timestamp":1772169013716,"version":"3.50.1"},"update-to":[{"DOI":"10.12688\/f1000research.73075.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2022,2,3]],"date-time":"2022-02-03T00:00:00Z","timestamp":1643846400000}}],"reference-count":18,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2022,2,3]],"date-time":"2022-02-03T00:00:00Z","timestamp":1643846400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000659","name":"Research Trainees Coordinating Centre","doi-asserted-by":"publisher","award":["PostDoctoralResearchFellow"],"award-info":[{"award-number":["PostDoctoralResearchFellow"]}],"id":[{"id":"10.13039\/501100000659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000659","name":"Research Trainees Coordinating Centre","doi-asserted-by":"publisher","award":["PDF10872"],"award-info":[{"award-number":["PDF10872"]}],"id":[{"id":"10.13039\/501100000659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns3:p>\n                    <ns3:bold>Introduction<\/ns3:bold>\n                  <\/ns3:p>\n                  <ns3:p>Fever during chemotherapy induced neutropenia is a common and potentially life-threatening complication of the treatment of childhood cancer. Predictions of poor outcome could be enhanced by incorporating serum biomarkers of inflammation at presentation and reassessment.<\/ns3:p>\n                  <ns3:p>\n                    <ns3:bold>Methods<\/ns3:bold>\n                  <\/ns3:p>\n                  <ns3:p>\n                    A prospective cohort study was conducted of children under 18 years old, being treated for cancer or a cancer-like condition, who presented with fever (\u2265 38.0\u00b0C) and neutropenia (neutrophil count &lt; 0.5*10\n                    <ns3:sup>9<\/ns3:sup>\n                    \/L). Clinical features were recorded, along with three experimental inflammatory biomarkers: procalcitonin (PCT), interleukin-6 (IL-6) and interleukin-8 (IL-8). Outcomes included serious medical complications (SMC): any infection related mortality, critical care and organ support, severe sepsis, septic shock, significant microbiologically defined infection, or radiologically confirmed pneumonia.\n                  <\/ns3:p>\n                  <ns3:p>\n                    <ns3:bold>Results<\/ns3:bold>\n                  <\/ns3:p>\n                  <ns3:p>Biomarker assessments were undertaken in 43 episodes of fever and neutropenia, from 31 patients aged between four months and 17 years old (median six years): 20 were female and 22 had acute leukaemia. Five episodes of SMC were noted. PCT, IL-6 and IL-8 had poor individual discriminatory ability (C-statistic 0.48 to 0.60) and did not add to the value of clinical risk stratification tools. Insufficient data were collected to formally assess the value of repeated assessments.<\/ns3:p>\n                  <ns3:p>\n                    <ns3:bold>Conclusions<\/ns3:bold>\n                  <\/ns3:p>\n                  <ns3:p>Incorporating serum biomarkers of inflammation at presentation of episodes of fever with neutropenia in childhood does not clearly improve risk stratification. The value of serial assessments requires further investigation.<\/ns3:p>","DOI":"10.12688\/f1000research.73075.2","type":"journal-article","created":{"date-parts":[[2022,2,3]],"date-time":"2022-02-03T12:00:34Z","timestamp":1643889634000},"page":"1070","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Prospective cohort study of the predictive value of inflammatory biomarkers over clinical variables in children and young people with cancer presenting with fever and neutropenia"],"prefix":"10.12688","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4938-9673","authenticated-orcid":false,"given":"Bob","family":"Phillips","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2022,2,3]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"3038-51","DOI":"10.1200\/JCO.2000.18.16.3038","article-title":"The Multinational Association for Supportive Care in Cancer risk index.","volume":"18","author":"J Klastersky","year":"2000","journal-title":"J. Clin. Oncol."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"228-33","DOI":"10.1136\/archdischild-2011-300178","article-title":"Procalcitonin.","volume":"96","author":"A Irwin","year":"2011","journal-title":"Arch. Dis. Child. Educ. Pract. Ed."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"733-5","DOI":"10.1586\/eri.12.56","article-title":"Complications of sepsis: the role of risk prediction rules, biomarkers and host genetics.","volume":"10","author":"G Haeusler","year":"2012","journal-title":"Expert Rev. Anti. 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Cancer."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"e28580","DOI":"10.1002\/pbc.28580","article-title":"Meta-analytic validation of new 'AUS' febrile neutropenia risk score.","volume":"68","author":"B Phillips","year":"2021","journal-title":"Pediatr. Blood Cancer."},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.17605\/OSF.IO\/CVFZB","article-title":"NIHR-PDF Biomarkers.","author":"B Phillips","year":"2021","journal-title":"OSF."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"2-8","DOI":"10.1097\/01.pcc.0000149131.72248.e6","article-title":"International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics.","volume":"6","author":"B Goldstein","year":"2005","journal-title":"Pediatr. Crit. 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Gibson, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada, 10 Feb 2022, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/10-1070\/v2#referee-response-122269","order":0,"name":"referee-response-122269","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.120929.r122270, Rejin Kebudi, Division of Pediatric Hematology-Oncology, Oncology Institute, Istanbul University, Istanbul, Turkey, 07 Feb 2022, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/10-1070\/v2#referee-response-122270","order":1,"name":"referee-response-122270","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"Dr Phillips (Post-Doctoral Research Fellow, PDF10872) was funded by the National Institute for Health Research (NIHR) for this research project. The views expressed in this paper are those of the author and not necessarily those of the NIHR, NHS or the UK Department of Health and Social Care. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":2,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}