Evaluation of hepatocyte growth factor and proinflammatory cytokines in patients with febrile neutropenia

Febrile neutropenia is the most important factor responsible for the morbidity and mortality in oncologic patients. Decreased amount of neutrophil count, increases the risk of severity and increased time extension of infection. Hepatocyte growth factor (HGF), also known to as hepatopoietin A or scatter factor, is a heterodimeric protein composed of a 69-kD a-subunit and a 34-kD b-subunit linked together by a disulphide bond. It has been proposed that the increase of HGF levels during the acute phase of infectious diseases might reflect regeneration process in injured organ. The present study aimed to determine serum HGF, CRP and proinflamatuar cytokines levels in the cases of febrile neutropenia and to examine whether sequential measurements of serum HGF and cytokines levels could be an indicator inthe treatment and prognosis of the disease. The study consisted of 20 patients with febrile neutropenia and 20 healthy volunteers. Sequential plasma HGF levels of the cases, including measurements at the onset, at the 48th hour and at the end of the treatment, were studied using ELISA method. Pre-treatment HGF levels of the patients were found significantly higher, relative to those in the control group. Furthermore, hour 48 and post-treatment HGF levels of the patients were observed to drop significantly in comparison to pre-treatment levels. Baseline plasma HGF levels of the cases were found correlated with CRP levels. Serum levels of TNF-? and IL-6 decreased significantly at the hour 48 and end of treatment. No significant difference was found between pre-treatment serum IL-8 and IL-1 levels and levels of the posttreatment. Our results indicate that sequentially measured HGF levels in febrileneutropenia cases may be an important biomarker in determining risk score and evaluating the prognosis of disease.