Contributions
Abstract: PB2050
Type: Publication Only
Background
Febrile neutropenia is a common occurrence in pediatric hematology patients due to myelosuppressive chemotherapy. Sepsis, which is an amplified, body-wide inflammatory response to an infection, is observed in 50% of patients with febril neutropenia. Effective management of sepsis during neutropenia stage could reduce the mortalities of cancer treatments. In addition to its direct role in promoting and regulating clot formation, it is documented in recent years that thrombin is a key component of inflammatory response also. It both regulates and enhances inflammatory responses against infections and tissue damage.
Aims
In our study, we aimed to observe the changes in thrombin formation in febrile neutropenia patients. Also we evaluate whether the amount of thrombin formation could be implified as a prognostic marker in febrile neutropenia.
Methods
Recruitment of patients took place at the Pediatric Hematology and Oncology Department of Pediatrics Hematology Oncology Training and Research Hospital of Ankara Health Sciences University between January to August 2016. Thrombin levels were measured by Thrombin Generation Test (TGT) by flourogenic method. Endogenous thrombin potentials (ETP; Total Thrombin Level in Samples) of 35 patients were evaluated. Results of patients were compared to results of 50 healthy children. Platelet Poor Plasma Samples of febrile neutropenia group were collected at initial admission, at 48.th hour and after recovery from neutropenia.
Results
Patient’s mean day of recovery from neutropenia was 19.8 ± 11.7 (min-max: 7-49). Mean ETP value at the 48th hour (1998 ± 1037 nanomol x minute ) was statistically higher than the mean ETP value of the initial admission (1471,8 ± 582 nanomol x minute ) (p:0.007), mean ETP value of control group (1260 ± 267 nanomol x minute ) (p:0.001) and mean ETP value of the time when neutropenia resolved (1492± 530 nanomol x minute ) (p: 0.008). Mean peak value of thrombin at the 48th hour (386 ± 239 nmol/L) was statistically higher than the mean peak value of the initial admission (271 ± 112 nmol/L) and the mean peak value of the time when neutropenia diminished (297 ± 123 nmol/L) (p: 0.02).
Conclusion
Thrombin is a multifunctional protein involves in coagulation, anticoagulation, platelet activation, endothelial activation, production of growth factors and proliferation of both smooth muscle cells and fibroblasts . Sepsis; is the main cause of mortality in the neutropenic phase following the treatment of malignancies. Our results support that thrombin formation may be used as a prognostic marker in pediatric patients with febrile neutropenia associated with chemotherapy, there is a need for further studies in larger subject groups.
Session topic: 31. Infectious diseases, supportive care
Keyword(s): Febrile neutropenia, Prognostic factor, Thrombin generation
Abstract: PB2050
Type: Publication Only
Background
Febrile neutropenia is a common occurrence in pediatric hematology patients due to myelosuppressive chemotherapy. Sepsis, which is an amplified, body-wide inflammatory response to an infection, is observed in 50% of patients with febril neutropenia. Effective management of sepsis during neutropenia stage could reduce the mortalities of cancer treatments. In addition to its direct role in promoting and regulating clot formation, it is documented in recent years that thrombin is a key component of inflammatory response also. It both regulates and enhances inflammatory responses against infections and tissue damage.
Aims
In our study, we aimed to observe the changes in thrombin formation in febrile neutropenia patients. Also we evaluate whether the amount of thrombin formation could be implified as a prognostic marker in febrile neutropenia.
Methods
Recruitment of patients took place at the Pediatric Hematology and Oncology Department of Pediatrics Hematology Oncology Training and Research Hospital of Ankara Health Sciences University between January to August 2016. Thrombin levels were measured by Thrombin Generation Test (TGT) by flourogenic method. Endogenous thrombin potentials (ETP; Total Thrombin Level in Samples) of 35 patients were evaluated. Results of patients were compared to results of 50 healthy children. Platelet Poor Plasma Samples of febrile neutropenia group were collected at initial admission, at 48.th hour and after recovery from neutropenia.
Results
Patient’s mean day of recovery from neutropenia was 19.8 ± 11.7 (min-max: 7-49). Mean ETP value at the 48th hour (1998 ± 1037 nanomol x minute ) was statistically higher than the mean ETP value of the initial admission (1471,8 ± 582 nanomol x minute ) (p:0.007), mean ETP value of control group (1260 ± 267 nanomol x minute ) (p:0.001) and mean ETP value of the time when neutropenia resolved (1492± 530 nanomol x minute ) (p: 0.008). Mean peak value of thrombin at the 48th hour (386 ± 239 nmol/L) was statistically higher than the mean peak value of the initial admission (271 ± 112 nmol/L) and the mean peak value of the time when neutropenia diminished (297 ± 123 nmol/L) (p: 0.02).
Conclusion
Thrombin is a multifunctional protein involves in coagulation, anticoagulation, platelet activation, endothelial activation, production of growth factors and proliferation of both smooth muscle cells and fibroblasts . Sepsis; is the main cause of mortality in the neutropenic phase following the treatment of malignancies. Our results support that thrombin formation may be used as a prognostic marker in pediatric patients with febrile neutropenia associated with chemotherapy, there is a need for further studies in larger subject groups.
Session topic: 31. Infectious diseases, supportive care
Keyword(s): Febrile neutropenia, Prognostic factor, Thrombin generation