Objective: The study aim was to compare the performance of interleukin-1
receptor antagonist (IL-1Ra) to C-reactive protein (CRP) and
procalcitonin (PCT) in early prediction of the clinical course of
febrile neutropenia. Methods: The study population consisted of 86
consecutive patients with febrile neutropenia who received intensive
chemotherapy for haematological malignancy between November 2009 and
November 2012 at the adult haematology ward of Kuopio University
Hospital. Twenty-three (27%) patients had acute myeloid leukaemia and 63
(73%) patients were autologous stem cell transplant recipients. IL-1Ra,
CRP and procalcitonin were measured at the onset of fever (d0), on day 1
(d1) and on day 2 (d2). Results: Eight patients developed severe
sepsis, including three patients with septic shock. Eighteen patients
had bacteraemia. After the onset of febrile neutropenia Youden´s indices
(with their 95% confidence intervals) to identify severe sepsis were
for IL-1Ra on d0 0.57 (0.20-0.71) and on d1 0.65 (0.28-0.78), for CRP on
d0 0.41 (0.04-0.61) and on d1 0.47 (0.11-0.67) and for PCT on d0 0.39
(0.05-0.66) and on d1 0.52 (0.18-0.76). Conclusions: In haematological
patients, IL-1Ra has a comparable capacity with CRP and PCT to predict
severe sepsis at the early stages of febrile neutropenia.