Table 2

Details of biomarkers, patients and endpoints in 25 included studies

Citation

Underlying conditions

Underlying conditions

Markers studied

Number of patients

Number of episodes

Endpoints studied

Comments

on endpoints


Ammann 2003

Pre-B-cell ALL = 94, Other diagnosis = 191

CRP

111

285

Significant bacterial infection

Defined as death from bacterial infection, a positive culture of normally sterile body fluids, radiologically proven pneumonia, clinically unequivocal diagnosis of a bacterial infection, or a serum CRP above 150 mg/L as an indirect sign suggesting severe bacterial infection


Barnes 2002

No data given

PCT

37

39

Length of stay

Stay of < 5d or ≥5d


de Bont 1999

ALL = 8, AML = 20, CML = 2, Lymphoma = 16, Solid tumor = 7

CRP, IL6, IL8

19

72

Bacteremia


Diepold 2008

ALL = 21, AML = 1, JMML = 1, Relapsed AML after SCT = 1, Solid tumor = 39, Hematological disorder after SCT = 4, Hematological disorder without SCT = 1

CRP, IL6, IL8

69

123

Bacteremia

Fever lasting ≥5d but culture -ve


Dylewska 2005 a and b

No data given

CRP, PCT

66

108

Bacteremia

Clinically defined infections (UTI, neurological, GI or respiratory)

Microbiologically defined other infection

FUO was the default category


El-Maghraby 2007

ALL = 37, AML = 39, Lymphoma = 39

CRP, IL8, MCP

76

85

Bacteremia or clinically documented infection


Hatzistilianou 2007

All patients had ALL

CRP, PCT

29

94

Microbiological or clinically documented infection (excludes viral)


Heney 1992

ALL = 17, AML = 10, Lymphoma = 2, Solid tumor = 18

CRP, IL6

33

47

Bacteremia


Hitoglou-Hatzi 2005

All patients had ALL

CRP, PCT, tADA

67

Not stated

Significant bacterial infection


Hodge 2006

No overall data given

IL8, IL5

31

31

Positive blood culture


Katz 1992

Haematological malignancy = 82, Solid tumor = 40

CRP

74

122

Clinically or bacteriologically documented infection

Septicemia (+ve blood cultures and unwell clinical appearance)


Kitanovski 2006

Hematological malignancy = 50, Solid tumor = 18

CRP, PCT, IL6

32

68

Bacteremia and clinical sepsis

Clinically or microbiologically documented local infection


Lehrnbecher 1999

ALL = 17, AML = 7, Lymphoma = 5, Solid tumor = 27

CRP, PCT, IL6

56

121

Clinically documented infection

Fungal infection

Bacteremia (gram-type)

FUO was the default category


Lehrnbecher 2004

ALL = 48, AML = 15, Lymphoma = 16, Histiocytosis = 1, Solid tumor = 66

IL6, IL8

146

311

Significant bacterial infection

Defined as bacteremia, localised infection or pneumonia


Riikonen 1992

No data given

IL6, IL1, TNF, SAA

46

105

Bacteremia

suspected sepsis

Focal infection

"No infection" was the default category


Riikonen 1993

ALL = 20, AML = 24, Solid tumor = 47

CRP

46

91

Bacteremia

suspected sepsis

Focal infection

"No infection" was the default category


Santolaya 1994

Leukemia = 47, Lymphoma = 17, Solid tumor = 11

CRP

75

85

Documented bacterial infection

Probable bacterial infection

Viral infection

Documented bacterial infection defined as bacteremia (two sets positive for commensals) or sterile site infection; Probable bacterial infection defined as cultures negative but severe medical course, for example, purulent gingivostomatitis, CXR+; FUO was the default category


Santolaya 2001

ALL = 40%, AML = 8%, Relapsed leukemia = 14%, Lymphoma = 6%, Sarcoma = 17%, Other solid tumor = 15%

CRP

257

447

Invasive bacterial infection

Defined as positive blood cultures - 2 for CoNS, positive bacterial culture from usually sterile site, or sepsis syndrome and/or focal organ involvement and haemodynamic instability and severe malaise


Santolaya 2002

ALL = 92, AML = 14, Lymphoma = 10, Solid tumor = 54

CRP

170

263

Invasive bacterial infection

Defined as positive blood cultures - 2 for CoNS, positive bacterial culture from usually sterile site, or sepsis syndrome and/or focal organ involvement and haemodynamic instability and severe malaise


Santolaya 2007

No overall data given

CRP

219

373

Death


Santolaya 2008

No overall data given on diagnoses.

CRP, PCT, IL8

278

566

Severe sepsis

Defined as sepsis + respiratory or cardiac compromise, or + 2 other-organ compromise) not apparent during the first 24 h of admission


Secmeer 2007

ALL and AML = 9, Lymphoma = 14, Sarcoma = 7, Histiocytosis = 1, Other solid tumor = 18

CRP, PCR, ESR

49

60

Bacteremia

Documented bacterial infection (microbiologically or clinically)

Duration of fever


Soker 2001

ALL = 17, AML = 4, Lymphoma = 2

IL6, IL8, IL2R, IL1, TNF-alpha

23

48

Bacteremia


Spasova 2005

ALL = 23, AML = 1, Lymphoma = 6, Solid tumor = 11

CRP, IL6, IL8, IL10

24

41

Bacteremia

Microbiologically or clinically proven local infections without bacteremia


Stryjewski 2005

ALL = 35, AML = 2, Sarcoma = 8, Other solid tumor = 11

PCT, IL6, IL8

56

Not stated

Sepsis

Septic shock

Sepsis (positive culture - two consecutive +ve if CoNS, fever, tachycardia, or tachypnoea); septic shock defined as sepsis plus need for inotropes/vasopressors


CRP, C-reactive protein; CoNS, coagulase negative staphylococcus; ESR, erythrocyte sedimentation rate; FUO, fever of unknown origin; IL, interleukin; MCP, monocyte chemoattractant protein; PCT, pro-calcitonin; SAA, serum amyloid protein A; tADA, t- Adenosine Deaminase; TNF, Tumor necrosis factor

Phillips et al. BMC Medicine 2012 10:6   doi:10.1186/1741-7015-10-6

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