{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T03:56:35Z","timestamp":1782964595128,"version":"3.54.5"},"reference-count":75,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T00:00:00Z","timestamp":1751414400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007817","name":"University of Rzesz\u00f3w","doi-asserted-by":"publisher","award":["none"],"award-info":[{"award-number":["none"]}],"id":[{"id":"10.13039\/501100007817","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: Febrile neutropenia is a frequent and potentially life-threatening complication in pediatric oncology patients receiving chemotherapy. Due to profound immunosuppression, early diagnosis of infections remains a major clinical challenge. This review evaluates the diagnostic and prognostic utility of infection biomarkers in children with chemotherapy-induced severe neutropenia. Methods: We reviewed clinical studies that assessed the diagnostic performance of inflammatory biomarkers\u2014including C-reactive protein (CRP), procalcitonin (PCT), interleukins (IL-6, IL-8, IL-10), and others\u2014in pediatric febrile neutropenia. The review includes data on sensitivity, specificity, predictive value, and clinical applications. Results: CRP remains a common but nonspecific marker, often insufficient for early stratification. PCT showed consistently high negative predictive value and early responsiveness to bacterial infections. IL-6 and IL-10 demonstrated strong early diagnostic accuracy in the early phase (AUC &gt; 0.80 in multiple studies) and were particularly useful in predicting septic shock when combined. IL-8, while less specific, may help rule out infection when levels are low. Emerging biomarkers such as presepsin, MR-proADM, and PSP showed promising diagnostic performance. Presepsin achieved near-perfect accuracy in some cohorts (AUC up to 0.996), outperforming CRP and PCT, though its ability to discriminate bacteremia at fever onset varied. MR-proADM demonstrated consistent AUCs above 0.75 and may support early sepsis identification. PSP was associated with significantly elevated levels in sepsis. Additional novel markers\u2014including sTNFR-II, sIL-2R, IP-10, Flt-3L, MCP-1-a, and MBL\u2014showed encouraging diagnostic profiles in individual studies, particularly due to high specificity, but require external validation. G-CSF also emerged as a promising candidate in multimarker models. In contrast, TNF-\u03b1 and IL-1\u03b2 displayed limited utility as standalone indicators. Conclusions: Biomarkers such as PCT, IL-6, Il-8, and IL-10 offer valuable tools for early infection detection and risk stratification in pediatric febrile neutropenia. Emerging markers\u2014including presepsin, MR-proADM, and PSP\u2014further enhance diagnostic precision and may support early identification of sepsis. Multimarker strategies, particularly those incorporating presepsin, IL-10, or MR-proADM, show potential to improve diagnostic performance beyond conventional markers. Further prospective validation is needed to optimize clinical implementation and guide personalized treatment decisions.<\/jats:p>","DOI":"10.3390\/cancers17132227","type":"journal-article","created":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T04:35:52Z","timestamp":1751517352000},"page":"2227","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Infection Biomarkers in Children with Chemotherapy-Induced Severe Neutropenia"],"prefix":"10.3390","volume":"17","author":[{"given":"Wioletta","family":"Bal","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, University of Rzeszow, 35-310 Rzeszow, Poland"},{"name":"Clinic of Pediatric Oncology and Hematology, State Hospital 2, 35-301 Rzeszow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7896-0907","authenticated-orcid":false,"given":"Zuzanna","family":"Piasecka","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, University of Rzeszow, 35-310 Rzeszow, Poland"},{"name":"Clinic of Pediatric Oncology and Hematology, State Hospital 2, 35-301 Rzeszow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaudia","family":"Szuler","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, University of Rzeszow, 35-310 Rzeszow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6862-9142","authenticated-orcid":false,"given":"Rados\u0142aw","family":"Chaber","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, University of Rzeszow, 35-310 Rzeszow, Poland"},{"name":"Clinic of Pediatric Oncology and Hematology, State Hospital 2, 35-301 Rzeszow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"328","DOI":"10.7326\/0003-4819-64-2-328","article-title":"Quantitative relationships between circulating leukocytes and infection in patients with acute leukemia","volume":"64","author":"Bodey","year":"1966","journal-title":"Ann. 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