Association Between Cytokine Concentration Kinetics and Prolonged Fever in Febrile Neutropenic Children with Bacteremia

Introduction: Although prolonged fever in patients with neutropenic fever (NF) during empirical antibiotic therapy could be caused by dysregulated immune responses, its association with cytokine concentrations has rarely been investigated. This study determined the kinetics of cytokine concentrations in pediatric patients with NF and bacteremia and evaluated the impact of cytokine concentration kinetics on prolonged fever.

Methods: Concentrations of 13 cytokines were measured on the initial day of NF (Day 1) and 3 days (Day 4) and 7 days (Day 8) later in 10 patients with NF with bacteremia, and their kinetics was determined. The results for each cytokine concentration on each sampling day were compared for patients with fever that lasted ⩾3 days and those with fever that lasted <3 days.

Results: Interleukin (IL)-6 ( < .001) and IL-10 ( = .001) concentrations were significantly higher on Day 1 than on Days 4 and 8. However, the increased IL-6 ( = 1.000) and IL-10 ( = 1.000) concentrations on Day 1 were not associated with prolonged fever (⩾3 days). For other cytokines, the concentrations measured on Days 1, 4, and 8 were similar regardless of fever duration.

Conclusion: Prolonged fever in patients with NF and bacteremia was not associated with a prolonged increase in a specific cytokine concentration.