Dimitrijević Jelena, Čalamać Marina, Đurmez Ognjen, Krstić Danijela, Stojanović Marko
Institute for Oncology and Radiology of Serbia, Belgrade, Serbia.
Institute of Medical Chemistry, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Clin Med Insights Oncol. 2024 Sep 24;18:11795549241281330. doi: 10.1177/11795549241281330. eCollection 2024.
Febrile neutropenia (FN) poses a significant challenge in cancer treatment, with a high incidence among patients undergoing standard therapies. Predicting FN complications and outcomes remains crucial for improving patient management strategies. Biomarkers, including procalcitonin and albumin, have garnered attention for their potential prognostic value in FN.
We conducted a prospective observational study at a tertiary hospital, enrolling 185 adult cancer patients experiencing FN episodes. We assessed serum albumin levels and incorporated them into the Multinational Association for Supportive Care in Cancer (MASCC) risk index to enhance risk stratification.
Serum albumin levels displayed promising prognostic utility in febrile neutropenia (FN). They exhibited moderate specificity and sensitivity in predicting mortality during FN and 28-day mortality. Serum albumin levels were significantly associated with gastrointestinal infections, serving as an independent predictor. Integrating serum albumin into the MASCC risk index improved predictive accuracy for FN mortality by 50%, 28-day mortality by 66.67%, and respiratory tract infections by 62.50%, enhancing in this way risk stratification for FN-related complications.
Serum albumin emerges as a promising biomarker for prognostication in FN, complementing existing risk assessment frameworks. Its incorporation into the MASCC risk index enhances predictive capabilities, aiding clinicians in identifying high-risk patients promptly. While albumin shows potential in predicting mortality and complications, further research is warranted to optimize sensitivity and specificity, ensuring its clinical utility.
发热性中性粒细胞减少症（FN）在癌症治疗中构成重大挑战，在接受标准治疗的患者中发病率很高。预测FN并发症和结局对于改善患者管理策略仍然至关重要。包括降钙素原和白蛋白在内的生物标志物因其在FN中的潜在预后价值而受到关注。
我们在一家三级医院进行了一项前瞻性观察性研究，纳入了185例经历FN发作的成年癌症患者。我们评估了血清白蛋白水平，并将其纳入癌症支持治疗多国协会（MASCC）风险指数中，以加强风险分层。
血清白蛋白水平在发热性中性粒细胞减少症（FN）中显示出有前景的预后效用。它们在预测FN期间的死亡率和28天死亡率方面表现出中等的特异性和敏感性。血清白蛋白水平与胃肠道感染显著相关，是一个独立的预测因素。将血清白蛋白纳入MASCC风险指数可将FN死亡率的预测准确性提高50%，28天死亡率的预测准确性提高66.67%，呼吸道感染的预测准确性提高62.50%，从而加强了FN相关并发症的风险分层。
血清白蛋白成为FN预后的一种有前景的生物标志物，补充了现有的风险评估框架。将其纳入MASCC风险指数可提高预测能力，帮助临床医生迅速识别高危患者。虽然白蛋白在预测死亡率和并发症方面显示出潜力，但仍需要进一步研究以优化敏感性和特异性，确保其临床效用。
