Significance of Interleukin-6 and C-Reactive Protein in Predicting Outcomes in Febrile Neutropenia in Children with Malignancy

Background: Febrile neutropenia (FN) is a common complication in children with cancer. We investigated the ability of interleukin-6 (IL-6) and C-reactive protein (CRP) to predict FN and fever in these patients. Methods: In this cross-sectional analytical study, all eligible patients diagnosed with hematological and non-hematological cancers referred to hematology, oncology wards of Motahari Hospital in Urmia, from 2021 to 2022 were selected by convenience method. Demographic information, type of malignancy, stage of malignancy treatment, drugs receiving chemotherapy, accompanying symptoms, test results and paraclinical findings were collected. We predefined cutoff values at 30 pg/mL for IL-6 and 30 mg/dL for CRP. Results: Of 30 pediatric cancer patients, 21 were male (70%) and nine were female (30%), with a mean age of 7.2±3.46 years. The mean duration of fever and hospital stay was 3.14±1.95 days and 7.85±2.8 days, respectively, in the group with IL-6 levels exceeding 30 pg/mL. In contrast, for those with IL-6 levels below 30 pg/mL, the mean duration of fever and hospitalization stood at 6.0±2.8 days and 10.6±3.8 days, respectively. A significant association was noted between IL-6 levels and both hospital stay (P=0.034) and fever duration (P=0.008). Conversely, no notable correlation was evident between CRP levels and the duration of hospitalization or fever in the participants under investigation (P≤0.79). Conclusion: Our findings suggest initial serum IL-6 levels may predict FN and fever in children with cancer. This makes IL-6 a potentially valuable tool for identifying low-risk patients.