Skip to main content

Advertisement

Log in

Evaluation of circulating soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) to predict risk profile, response to antimicrobial therapy, and development of complications in patients with chemotherapy-associated febrile neutropenia: a pilot study

  • Original Article
  • Published:
Annals of Hematology Aims and scope Submit manuscript

Abstract

The soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) is a useful marker of infection in patients with sepsis, but has not been adequately evaluated in patients with chemotherapy-associated febrile neutropenia (FN). The value of sTREM-1 in this setting has been tested in a retrospective, pilot study using stored serum from 48 cancer patients with documented FN. On presentation, patients were categorized according to the Talcott risk-index clinical score. Circulating soluble sTREM-1 was measured using an ELISA procedure, while procalcitonin (PCT) or interleukins 6 (IL-6) and 8 (IL-8), included for comparison, were measured using an immunoluminescence-based assay and Bio-Plex® suspension bead array system, respectively. Circulating concentrations of both sTREM-1 and PCT were significantly (P < 0.05) elevated in patients at high risk for complications or death, as predicted by the Talcott score and were significantly lower in patients who responded to empiric antimicrobial agents. Neither IL-6 nor IL-8 accurately predicted serious complications in patients with FN. These observations, albeit from a pilot study, demonstrate that sTREM-1 is indeed elevated in high-risk patients with FN and is potentially useful to predict their clinical course, either together with, or as an alternative to PCT.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Kuderer NM, Dale DC, Crawford J, Cosler LE, Lyman GH (2006) Mortality, morbidity, and cost associated with febrile neutropenia in adult cancer patients. Cancer 106(10):2258–2266

    Article  PubMed  Google Scholar 

  2. Talcott JA, Finberg R, Mayer RJ et al (1988) The medical course of cancer patients with fever and neutropenia. Arch Int Med 148:2561–2568

    Article  CAS  Google Scholar 

  3. Klastersky J, Paesmans M, Rubenstein EB, Boyer M, Elting L, Feld R, Gallagher J, Herrstedt J, Rapoport B, Rolston K, Talcott JA (2000) The multinational association for supportive care in cancer risk-index: a multinational scoring system for identifying low-risk febrile neutropenic cancer patients. J Clin Oncol 18:3038–3051

    PubMed  CAS  Google Scholar 

  4. Nakagawa Y, Suzuki K, Masaoka T (2009) Evaluation of the risk factors for febrile neutropenia associated with hematological malignancy. J Infect Chemother 15:174–179

    Article  PubMed  Google Scholar 

  5. Sakr Y, Sponholz C, Tuche F, Brunkhorst F, Reinhart K (2008) The role of procalcitonin in febrile neutropenic patients: review of the literature. Infection 36:396–407

    Article  PubMed  CAS  Google Scholar 

  6. Jimeno A, Garcia-Velasso A, del Val O, González-Billalabeitia E, Hernando S, Hernández R, Sánchez-Muňoz A, López-Martin A, Durán I, Robles L, Cortes-Funes H, Paz-Ares L (2004) Assessment of procalcitonin as a diagnostic and prognostic marker in patients with solid tumors and febrile neutropenia. Cancer 100:2462–2469

    Article  PubMed  CAS  Google Scholar 

  7. Uys A, Rapoport BL, Fickl H, Meyer PWA, Anderson R (2007) Prediction of outcome in cancer patients with febrile neutropenia: comparison of the Multinational Association of Supportive Care in Cancer risk-index score with procalcitonin, C-reactive protein, serum amyloid A, and interleukins-1β, -6, -8 and -10. Eur J Cancer Care 16:475–483

    Article  CAS  Google Scholar 

  8. Persson L, Söderquist B, Engervall P, Vikerfors T, Hansson L-O, Tidefelt U (2005) Assessment of systemic inflammation markers to differentiate a stable from a deteriorating clinical course in patients with febrile neutropenia. Eur J Haematol 74:297–303

    Article  PubMed  CAS  Google Scholar 

  9. Massaro KSR, Costa SF, Leone C, Chamone DAF (2007) Procalcitonin (PCT) and C-reactive protein (CRP) as severe systemic infection markers in febrile neutropenic adults. BMC Infect Dis 7:137. doi:10,1186/1471-2334-7-137

    Article  PubMed  Google Scholar 

  10. Prat C, Sancho JM, Dominguez J, Xicoy B, Giminez m, Ferra C, Blanco S, Lacoma A, Ribera JM, Aurina V (2008) Evaluation of procalcitonin, neopterin, C-reactive protein, IL-6 and IL-8 as a diagnostic marker of infection in patients with febrile neutropenia. Leuk Lymphoma 49:1752–1761

    Article  PubMed  CAS  Google Scholar 

  11. Semeraro M, Thomée C, Rolland E, Le Deley MC, Rosselini D, Troalen F, Amoroso L, Drubel M, Hartmann O (2010) A predictor of unfavourable outcome in neutropenic paediatric patients presenting with fever of unknown origin. Pediatr Blood Cancer 54:284–290

    PubMed  Google Scholar 

  12. Schultz MJ, Determann RM (2008) PCT and sTREM-1: the markers of infection in critically-ill patients? Med Sci Monit 14:RA241–RA247

    PubMed  Google Scholar 

  13. Ford JW, McVicar DW (2009) TREM and TREM-like receptors in inflammation and disease. Curr Opin Immunol 21:1–9

    Article  Google Scholar 

  14. Jiyong J, Tiancha H, Wei C, Huahao S (2009) Diagnostic value of the soluble triggering receptor expressed on myeloid cells-1 in bacterial infection: a meta-analysis. Intensive Care Med 35:587–595

    Article  PubMed  Google Scholar 

  15. Tejera A, Santolaria F, Diez M-L, Alemán-Valls M-R, Gonzáles-Reimers E, Martínez-Riera A, Milena-Abril A (2007) Prognosis of community acquired pneumonia (CAP): value of triggering receptor expressed on myeloid cells-1 (TREM-1) and other mediators of the inflammatory response. Cytokine 38:117–123

    Article  PubMed  CAS  Google Scholar 

  16. Lin CH, Ho CC, Yao M, Hsu SC, Yu CJ (2009) sTREM-1 (soluble triggering receptor expressed on myeloid cells-1) as marker indicating infection in patients with neutropenic fever. Am J Respir Crit Care Med 179:A4704

    Google Scholar 

  17. Uys A, Rapoport BL, Anderson R (2004) Febrile neutropenia: a prospective study to validate the Multinational Association of Supportive Care of Cancer risk-index score. Support Care Cancer 12:555–560

    Article  PubMed  Google Scholar 

  18. Giamarellou H, Giamarellos-Bourboulis EJ, Repoussis P et al (2004) Potential use of procalcitonin as a diagnostic criterion in febrile neutropenia: experience from a multicenter study. Clin Microbiol Infect 10:628–633

    Article  PubMed  CAS  Google Scholar 

  19. Stryjewski GR, Nylen ES, Bell MJ et al (2005) Interleukin-6, interleukin-8, and a rapid and sensitive assay for calcitonin precursors for the determination of bacterial sepsis in febrile neutropenic children. Pediatr Crit Care Med 6:129–135

    Article  PubMed  Google Scholar 

  20. Porfyridis I, Plachouras D, Karagianni V, Kotanidou A, Papiris SA, Giamarellou H, Giamarellos-Bourboulis EJ (2010) Diagnostic value of triggering receptor expressed on myeloid cells-1 and C-reactive protein for patients with lung infiltrates: an observational study. BMC Infect Dis 10:286–295

    Article  PubMed  Google Scholar 

  21. Talcott JA, Whalen A, Clark J et al (1994) Home antibiotic therapy for low risk cancer patients with fever and neutropenia: a pilot study of 30 patients based on a validated prediction rule. J Clin Oncol 12:107–114

    PubMed  CAS  Google Scholar 

  22. Lav RC, King SM, Richardson SE (1994) Early discharge of pediatric febrile neutropenic cancer patients by substitution of oral for intravenous antibiotics. Pediatr Hematol Oncol 11:417–421

    Article  Google Scholar 

  23. Talcott JA, Siegel RD, Finberg R et al (1992) Risk assessment in cancer patients with fever and neutropenia. A prospective, two-center validation of a prediction rule. J Clin Oncol 10:316–322

    PubMed  CAS  Google Scholar 

  24. Han YY, Doughty LA, Kofos D, Sasser H, Carcillo JA (2003) Procalcitonin is persistently increased among children with poor outcome from bacterial sepsis. Pediatr Crit Care Med 4:21–25

    Article  PubMed  Google Scholar 

  25. Sarmati L, Beltrame A, Dori L, Maffongelli G, Cudillo L, De Angelis G, Picardi A, Ottaviani L, Cefalo MG, Venditti A, Amadori S, Arcese W, Andreoni M (2010) Procalcitonin is a reliable marker of severe systemic infection in neutropenic haematological patients with mucositis. Am J Hematol 85(5):380–383

    PubMed  CAS  Google Scholar 

  26. Kelso A (1998) Cytokines: principles and prospects. Immunol Cell Biol 76:300–317

    Article  PubMed  CAS  Google Scholar 

  27. Yamamura M, Uyemura K, Deans RJ et al (1991) Defining protective responses to pathogens: cytokine profiles in leprosy lesions. Science 254:277–279

    Article  PubMed  CAS  Google Scholar 

  28. Hakim H, Flynn PM, Srivastava DK, Knapp KM, Li C, Okuma J, Gaur AH (2010) Risk prediction in pediatric cancer patients with fever and neutropenia. Pediatr Infect Dis J 29:53–59

    Article  PubMed  Google Scholar 

  29. Karapanagiotou EM, Pelekanou E, Charpidou A et al (2008) Soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) detection in cancer patients: a prognostic marker for lung metastases from solid malignancies. Anticancer Res 28:1411–1416

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to R. Anderson.

Electronic supplementary material

Below is the link to the electronic supplementary material.

ESM 1

(PDF 34 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kwofie, L., Rapoport, B.L., Fickl, H. et al. Evaluation of circulating soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) to predict risk profile, response to antimicrobial therapy, and development of complications in patients with chemotherapy-associated febrile neutropenia: a pilot study. Ann Hematol 91, 605–611 (2012). https://doi.org/10.1007/s00277-011-1339-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00277-011-1339-4

Keywords

Navigation