C-Reactive Protein in the Follow-up and Estimation of Infections in Acute Leukemic PatientsVahap Aslan, O. Meltem Akay, Zafer GülbaşDepartment Of Hematology, Osmangazi University Medical School, Eski¾ehir, Turkey
Fifty-five febrile neutropenic episodes were monitored by C-reactive protein (CRP) in 26 patients with acute leukemia. In nonfebrile period of patients, serum CRP level was 0.89 mg/dL (range 0.1-8.8 mg/dL) while it was found to be raised to 9.57 mg/dL (range 0.5-24.1 mg/dL) in the febrile group (p= 0.0001). Serum CRP level at the onset of fever was 9.25 mg/dL (range 0.1-16.2 mg/dL) in patients in whom fever was treated succesfully with antipseudomonal beta-lactam antibiotic and aminoglycoside therapy declined to normal levels (p= 0.01); 17.0 mg/dL (range 5.2-33.5 mg/dL) in patients still persisting fever with this combined therapy and so obtained vancomycin (p= 0.001); 16.6 mg/dL (range 0-38.7 mg/dL) in patients required amphotericin B in addition (p= 0.001). In the initial febrile episode; fever resolved at day 3.3 ± 1.21 in patients with serum CRP value below 5 mg/dL; at day 4.42 ± 1.88 in patients with serum CRP value between 10-15 mg/dL; at day 5.14 ± 1.68 in patients with serum CRP value above 15 mg/dL. There was no statistical difference at the time of fever resolution among the first three groups. There was a remarkable difference between groups with CRP values below 5 mg/dL and above 15 mg/dL (p= 0.04). We conclude that determination of serum CRP level before and after infection in febrile neutropenic patients is useful for the follow-up and estimation of febrile neutropenic episode in acute leukemic patients. Keywords: C-reactive protein, Acute leukemia, Infection.
Akut Lösemik Hastalarda İnfeksiyonun İzlenmesi ve Değerlendirilmesinde C-Reaktif ProteinVahap Aslan, O. Meltem Akay, Zafer GülbaşDepartment Of Hematology, Osmangazi University Medical School, Eski¾ehir, Turkey
Akut lösemi tanısı almış 26 hastada 55 febrilnötropenik atak C-reaktif protein (CRP) ile izlendi. Serum CRP düzeyi febril olmayan dönemde 0.89 mg/dL iken febril dönemde 9.57 mg/dL bulundu (p= 0.0001). Ateşin antipsödomonal beta-laktam antibiyotik ve aminoglikozid ile düştüğü hastalarda CRP düzeyleri normale indi (p= 0.01) ancak eteşi devam eden ve vankomisin ya da amfoterisin-B eklenmesi gerekenlerde yüksek kaldı. Ateşin düşmesi ile serum CRP düzeyleri 5 mg/dL altında ve 15 mg/dL üstünde olanlarda fark saptandı (p= 0.04). Febril nötropenik hastalarda önce ve sonra serum CRP düzey tayini izleme ve değerlendirilmesi için akut lösemik hastalarda yararlıdır. Anahtar Kelimeler: C-reaktif protein, Akut lösemi, Ý, nfeksiyon. Turk J Haematol
Vahap Aslan, O. Meltem Akay, Zafer Gülbaş. C-Reactive Protein in the Follow-up and Estimation of Infections in Acute Leukemic Patients. Turk J Hematol. 2003; 20(2): 75-80
Corresponding Author: Vahap Aslan, Türkiye |
|