Department of Genomic Medicine, Rigshospitalet, 2100 Copenhagen, Denmark.
Department of Paediatrics and Adolescent Medicine, Rigshospitalet, 2100 Copenhagen, Denmark.
Int J Mol Sci. 2023 Jun 16;24(12):10251. doi: 10.3390/ijms241210251.
Improved methods are needed for diagnosing infectious diseases in children with cancer. Most children have fever for other reasons than bacterial infection and are exposed to unnecessary antibiotics and hospital admission. Recent research has shown that host whole blood RNA transcriptomic signatures can distinguish bacterial infection from other causes of fever. Implementation of this method in clinics could change the diagnostic approach for children with cancer and suspected infection. However, extracting sufficient mRNA to perform transcriptome profiling by standard methods is challenging due to the patient's low white blood cell (WBC) counts. In this prospective cohort study, we succeeded in sequencing 95% of samples from children with leukaemia and suspected infection by using a low-input protocol. This could be a solution to the issue of obtaining sufficient RNA for sequencing from patients with low white blood cell counts. Further studies are required to determine whether the captured immune gene signatures are clinically valid and thus useful to clinicians as a diagnostic tool for patients with cancer and suspected infection.
需要改进方法来诊断患有癌症的儿童的传染病。大多数儿童发热并非细菌感染所致，他们因此接受了不必要的抗生素治疗和住院治疗。最近的研究表明，宿主全血 RNA 转录组特征可区分细菌感染与其他发热原因。该方法在临床上的应用可能会改变对疑似感染癌症儿童的诊断方法。然而，由于患者白细胞 (WBC) 计数低，通过标准方法提取足够的 mRNA 来进行转录组分析具有挑战性。在这项前瞻性队列研究中，我们通过使用低投入方案成功地对疑似感染白血病的儿童的 95%的样本进行了测序。这可能是解决从白细胞计数低的患者中获得足够用于测序的 RNA 的问题的一种方法。需要进一步的研究来确定捕获的免疫基因特征是否具有临床有效性，从而对临床医生作为癌症和疑似感染患者的诊断工具是否有用。
