Sepsis and mucositis-related biomarkers in adult hematologic patients with febrile neutropenia

Febrile neutropenia (FN) is a common complication of chemotherapy and potentially fatal. It is often associated with mucositis. Timely recognition of complications enables early supportive treatment and potentially reduces mortality. Common diagnostic parameters are often nonspecific or have slow kinetics. This study examines the applicability of mucosa-related biomarkers in the recognition of complicated course among 78 adult hematologic patients with FN after intensive chemotherapy. Plasma concentrations of citrulline, intestinal fatty acid binding protein (I-FABP), zonula occludens-1 (ZO-1) and alpha-1 acid glycoprotein (α1AGP), as well as C-reactive protein (CRP) and procalcitonin (PCT), were measured at the onset of fever and the following two days. All except ZO-1 showed a significant trend. Concentrations of CRP, PCT, citrulline and α1AGP were higher with a complicated course. Patients with severe sepsis had higher levels of PCT and lower levels of I-FABP. In conclusion, measurement of mucosa-related biomarkers might help predict the course of FN.