B-113 The value of plasma presepsin as a diagnostic and prognostic biomarker for Febrile Neutropenia in Children

Abstract Background Febrile neutropenia (FN) is a prevalent infectious complication which observed in pediatric cancer patients undergoing anticancer treatment. The presepsin is a reliable biomarker for sepsis, but its clinical value in the context of pediatric patients FN remains unclear. This study aimed to evaluate the performance of presepsin in the entire course of pediatric patients with FN. Methods In this prospective study, a total of 108 pediatric hematological tumor patients with neutropenia were recruited, of which 23 had febrile neutropenia. Daily blood samples were collected and four inflammation biomarkers, presepsin, procalcitonin (PCT), interleukin-6 (IL-6), and C-reactive protein (CRP) analyzed. Clinical and laboratory parameters were collected and assessed the performance of diagnostic and prognostic value of biomarkers for FN. Results Concentrations of presepsin?PCT?IL-6 and CRP were prospectively measured in 57 FN episodes experienced by 23 cases of malignant hematological diseases in children. The concentrations of presepsin, PCT, and CRP levels were significantly elevated on 72h hours before onset than that of control. Only the concentration of Presepsin at FN onset was significantly higher than 72h before FN onset. The ROC of presepsin, PCT, IL-6 and CRP for FN diagnosis 2h before FN onset were 0.9118, 0.8214, 0.9052, 0.8286, respectively. For prognosis, the levels of presepsin were consistently significantly higher at every time point in patients with unfavorable outcomes than those with favorable outcomes. Conclusion Presepsin demonstrated the best performance in both early diagnosis and prognosis assessment of FN, indicating that it is a reliable biomarker for managing the entire FN process. Close monitoring of presepsin may enable earlier intervention in FN, reducing the occurrence of adverse events caused by infection.