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Asymmetric dimethylarginine in the assessment of febrile neutropenia in hematological patients
- Source :
- Scandinavian journal of clinical and laboratory investigation. 77(2)
- Publication Year :
- 2017
-
Abstract
- Asymmetric dimethylarginine (ADMA) has been recognized as an independent prognostic factor for sepsis mortality in intensive care units. No data are available on kinetics or prognostic value of ADMA in hematological patients. We evaluated the ability of ADMA to act as a predictor for complicated course of febrile neutropenia, defined as bacteremia and/or septic shock in adult hematological patients receiving intensive chemotherapy. This prospective study included 87 adult hematological patients with febrile neutropenia after an intensive chemotherapy for acute myeloid leukemia (AML) or after an autologous stem cell transplantation (ASCT). Plasma ADMA and serum C-reactive protein (CRP) levels were measured from the onset of fever (d0) and for 2 days (d1-d2) thereafter. The levels of ADMA were stable or had only minimal changes during the study period. There was no difference between the levels at any time-point in patients having complicated course compared to those without it. On the other hand, CRP levels were significantly higher on d1 (p = 0.016) in patients with bacteremia and/or septic shock than in those without. ADMA was not able to differentiate hematological patients with a complicated course from those without complications. Elevated ADMA levels are probably associated with organ dysfunction, which is rare in this group of patients, of whom about 95% can be successfully managed at the hematology ward.
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
Clinical Biochemistry
Antineoplastic Agents
Bacteremia
Arginine
Gastroenterology
Transplantation, Autologous
Sepsis
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Autologous stem-cell transplantation
Intensive care
Internal medicine
medicine
Humans
Prospective Studies
Intensive care medicine
Aged
Febrile Neutropenia
biology
Septic shock
business.industry
C-reactive protein
030208 emergency & critical care medicine
General Medicine
Middle Aged
medicine.disease
Shock, Septic
Leukemia, Myeloid, Acute
C-Reactive Protein
chemistry
030220 oncology & carcinogenesis
biology.protein
Female
Asymmetric dimethylarginine
business
Febrile neutropenia
Biomarkers
Stem Cell Transplantation
Subjects
Details
- ISSN :
- 15027686
- Volume :
- 77
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Scandinavian journal of clinical and laboratory investigation
- Accession number :
- edsair.doi.dedup.....525ae376bd3ed43fc19bba0e52e6232f