Comparison of the diagnostic power of cytokine patterns and procalcitonin for predicting infection among paediatric haematology/oncology patients

Abstract Objectives To evaluate the diagnostic power of the cytokine patterns and serum procalcitonin (PCT) level for predicting infection in paediatric haematology–oncology patients. Methods Retrospective study including hospitalized children with haematology–oncology disease was conducted and their serum T helper type 1/type 2 cytokines were measured by a flow cytometric method. According to clinical symptoms, imaging and microbiological findings, febrile episodes were divided into five diagnostic groups serving as reference standard; and also grouped according to disease severity. A control group consisted of afebrile children. Results A total of 3023 samples (2819 febrile episodes and 204 control samples) derived from 992 children (including 164 afebrile control patients) were obtained. Interleukin-6 (IL-6) and IL-10 levels as well as their positivity rates were significantly higher among children with bacteraemia than for the viral infection and control groups. Among children with bacteraemia, 92.8% (297/320) and 82.2% (263/320) had increased IL-6 and IL-10 levels that exceeded the upper limit of the normal range, respectively. The positivity rates of PCT and C-reactive protein were only 33.8% (108/320) and 73.1% (234/320), respectively, significantly lower than those of IL-6 and IL-10 (p  Conclusion Cytokine patterns of IL-6 and IL-10 showed higher diagnostic accuracy than PCT for bacteraemia and severe infections among febrile children with haematology/oncology disease.