| Prognostic role of midregional proadrenomedullin in predicting infection in pediatric cancer with febrile neutropenia |
Seham Ragab1, Sara El-Deeb2, Ahmed Saeed3, Asmaa Mahmoud1 
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1Department of Pediatrics, Faculty of Medicine, Menoufia University, Shebin Elkom, Egypt
2Department of Clinical Pathology, Faculty of Medicine, Menoufia University, Shebin Elkom, Egypt
3Egyptian Ministry of Health, Cairo, Egypt |
Correspondence:
Asmaa Mahmoud, Email: asmaasoliman50@gmail.com
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Received: 25 October 2024 • Revised: 8 December 2024 • Accepted: 20 December 2024 |
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| Abstract |
Background
Febrile neutropenia (FN) remains an important complication of cytotoxic chemotherapy for which an urgent and appropriate evaluation is imperative.
Purpose
To assess the diagnostic and prognostic roles of mid-regional pro-adrenomedullin (MR-ProADM) levels in predicting infection in patients with FN.
Methods
This comparative cross-sectional study included 137 patients with chemotherapy-induced FN. Complete blood count, C-reactive protein (CRP), procalcitonin, and MR-ProADM were evaluated on the 1st day of FN. Chest computed tomography (CT) was performed on the 5th day.
Results
MR-ProADM levels were significantly higher in patients with FN than in controls. CRP and MR-ProADM levels were significantly higher and ANC was significantly lower in patients with versus without bacterial infections. CRP, procalcitonin, and MR-ProADM levels were significantly negatively correlated with absolute neutrophil count (ANC). CRP, procalcitonin, and MR-ProADM levels were significantly and positively correlated with FN degree, FN duration, and hospital stay length. A multivariate regression analysis showed that a longer FN duration and hospital stay length, along with elevated CRP, procalcitonin, and MR-ProADM levels, were significant risk factors for mortality.
Conclusion
MR-ProADM is a reliable prognostic and diagnostic tool for predicting infection in patients with FN.
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| Key Words:
Febrile neutropenia, Midregional proadrenomedullin, Pediatric cancer |
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