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.
