Evaluation of adrenomedullin, C-reactive protein and procalcitonin in febrile neutropenia

Bio-indicators play on important role in early detection of FN in patients followed under the diagnosis of hematology malignancy, in acquaintace with possible etiological agents and in prevention of morbidity and mortality coosed by FN. This study aims at evaluating the role of serum adrenomedullin (ADM) at febrile neutropenia (FN) comparing the C-reactive protein (CRP) with procalcitonin (PCT). This is a prospective study of 33 febrile neutropenia attackks of 31 hematology malignancy patients monitored at the medical school of Gaziantep university Şahinbey araştırma ve uygulama hastahanesi, the departmant of hematology. In the case febrile neutropenia,blood samples were taken from the patients and serum adrenomedulin were compared to C-reactive protein (CRP) and procalcitonin. During this stady 33 FN attackks of patients at an avarage age of 38 (famale/male=1/2) were searched.The rate of hematology malignancy of the patients monitored is as follows: ALL(%42), AML (%39) ve MM (%9), AA(%3), MDS(%3) HL(%3). On the 18 th day of the patients acceptance into the service, (min:2-max:52) FN attackks have occurred.During chemotherapy,approximately after 8 days ,there occurred FN attackks.The period the patients stayed at neutropenia was 17 days on average.We had divided the FN into 3 categories depending on the seriosness of the enfection and the feverish neutropenia guides: (CDI,FUO, MDI).In this stady the percent age of CDI,FUO,MDI groups are as fallows alternately: %33,%39,%30. During this stady 18 patients (%54) lost their lives. There has been detected a positive,high and statisticcally significant relationship between the 3rd and 7rd (third and seventh) day values of CRP in MDI group (p<0,05). As for PTC, there has been detected a positive, high degree and statisticcally significant relationship between the values of zeroth, third and seventh days of MDI group. Between the CRP-PCT measurements of FN on the zeroth, third and seventh days, there has been observed a positive statisticcally significant relationship (p<0,05). While there was no significant relationship between MDI and FOU groups of adrenomedullin FN, the seventh day ADM level of CDI group was detected higher than the ADM level on the zeroth day. At the same time, there has been detected a positive correlation between the levels of ADM in serum and CRP, PCT levels (p<0,05). As bio-indicatotors in FN follow ups, in a dedermined infection group, of CRP and PCT, there was high and statisticcally significant relationship. From the application of FN (zeroth day) to the seventh day, CRP and PCTdegrees continued high and meaningful and there was a positive correlation between CRP-PCT levels. Under the light of present findings, it is obvious that CRP and PCT are parameters to be used for the detection of existing infection, the diagnosis and follow up treatmen among febrile neutropenia patients. While there was no meaningful correlation between MDI, FOU groups of adrenomedullin, FN seventh day ADM level of CDI group