Abstract
BACKGROUND: Febrile neutropenia (FN) is a prevalent infectious complication in paediatric cancer patients undergoing anticancer treatment. Presepsin is a reliable biomarker for sepsis; however, its clinical value in the context of paediatric FN remains unclear. This study aimed to evaluate the efficacy of presepsin in the entire course of paediatric patients with FN. METHODS: In this prospective study, 108 paediatric patients with haematological tumours complicated with neutropenia were recruited, of whom 23 had febrile neutropenia. Blood samples were collected daily, and four inflammation biomarkers, presepsin, procalcitonin (PCT), interleukin-6 (IL-6) and C-reactive protein (CRP), were analyzed. Clinical and laboratory parameters were collected, and the diagnostic and prognostic value of biomarkers for FN was assessed. RESULTS: The concentrations of presepsin, PCT, IL-6 and CRP were prospectively measured in 57 FN episodes in 23 cases of malignant haematological diseases in children. The concentrations of presepsin, PCT and CRP were significantly elevated 72 h before onset compared to those in the control group. Only the concentration of presepsin at FN onset was significantly higher than 72 h before FN onset. The area under the curve (AUC) of presepsin, PCT, IL-6 and CRP for FN diagnosis 24 h before FN onset were 0.9118, 0.8214, 0.9052 and 0.8286, respectively. For prognosis, the levels of presepsin were consistently and significantly higher at every time point in patients with unfavourable outcomes than in those with favourable outcomes. CONCLUSION: Presepsin demonstrated the best performance in both the early diagnosis and prognosis assessment of FN, indicating that it is a reliable biomarker for managing the entire FN process. Close monitoring of presepsin may enable earlier intervention for FN, reducing the occurrence of adverse events caused by infection.