Clin Exp Pediatr.  2025 Jun;68(6):445-453. 10.3345/cep.2024.01620.

Prognostic role of mid-regional pro-adrenomedullin in predicting infection in pediatric cancer with febrile neutropenia

• Ragab SM
• El-Deeb SM
• Saeed A
• Mahmoud AA

• KMID: 2569700
• DOI: http://doi.org/10.3345/cep.2024.01620

Abstract

Background
Febrile neutropenia (FN) remains an important complication of cytotoxic chemotherapy for which an urgent and appropriate evaluation is imperative. Purpose: To assess the diagnostic and prognostic roles of mid-regional pro-adrenomedullin (MR-ProADM) levels in predicting infection in patients with FN.
Methods
This comparative cross-sectional study included 137 patients with chemotherapy-induced FN. Complete blood count, C-reactive protein (CRP), procalcitonin (PCT), and MR-ProADM were evaluated on the 1st day of FN. Chest computed tomography was performed on the 5th day.
Results
MR-ProADM levels were significantly higher in patients with FN than in controls. CRP and MR-ProADM levels were significantly higher and absolute neutrophil count (ANC) was significantly lower in patients with versus without bacterial infections. CRP, PCT, and MR-ProADM levels were significantly negatively correlated with ANC. CRP, PCT, and MR-ProADM levels were significantly and positively correlated with FN degree, FN duration, and hospital stay length. A multivariate regression analysis showed that a longer FN duration and hospital stay length, along with elevated CRP, PCT, and MR-ProADM levels, were significant risk factors for mortality.
Conclusion
MR-ProADM is a reliable prognostic and diagnostic tool for predicting infection in patients with FN.

Keyword

Febrile neutropenia; Mid-regional pro-adrenomedullin; Pediatric cancer