Diagnostic relevance of interleukin-6 and tumor necrosis factor alpha in discriminating high risk and low risk groups in febrile patiens with neutropenia
The present study was designed to determine diagnostic value of IL-6 and TNF-? in patients with fever and neutropenia. This is a prospective study of 133 patients admitted to two university hospital in Tehran, Iran with fever and neutropenia. Patients were divided two groups as low risk and high-risk groups. Cytokines level compared with Mann-Whitney test in study groups of patients and ROC curves used to determine best cut-off points level for cytokines discriminating risk groups. Mean age of patients was 26.8±2.5 years and 7.5% of patients allocated in low risk group. The mean IL-6 and TNF-? serum level below 17 pg mL- was defined as best cut-off point determining low risk group patients with sensitivity and specificity of 70 and 67.5% respectively. However, we cannot define a statistically significant cut-off point for TNF-? to use as a diagnostic test. 13.5% of patients of our study have positive blood cultures (6% gram-negative, 6% gram- positive, 1.5% fungi), but no statistical difference had found in serum IL-6 and TNF-? levels in blood culture groups. Despite our findings about IL-6 diagnostic value in neutropenic patients with fever and its advantages in discriminating risk groups of patients it seem necessary to design a randomized controlled trial before use of this marker. © 2007 Asian Network for Scientific Information.