Neutrophil CD64 can be an early predictor for sepsis during febrile neutropenic episodes in children with cancer: a case control study

Abstract Background Febrile neutropenia (FN) is a common treatment-related complication in pediatric cancer patients with substantial morbidities and mortalities. Previous studies reported that neutrophil CD64 (n CD64) had higher diagnostic accuracy for infection with high sensitivity and specificit...

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Main Authors: Marwa Zakaria, Nehad Karam, Tamer Hassan, Nahla Zidan, Asmaa Abdelsalam, Raghdaa A. Ramadan, Marwa L. M. Rashad, Eman Abdelaziz, Ahmed Ramadan, Ahmed A. Ali
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Italian Journal of Pediatrics
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Online Access:https://doi.org/10.1186/s13052-025-01979-9
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author Marwa Zakaria
Nehad Karam
Tamer Hassan
Nahla Zidan
Asmaa Abdelsalam
Raghdaa A. Ramadan
Marwa L. M. Rashad
Eman Abdelaziz
Ahmed Ramadan
Ahmed A. Ali
author_facet Marwa Zakaria
Nehad Karam
Tamer Hassan
Nahla Zidan
Asmaa Abdelsalam
Raghdaa A. Ramadan
Marwa L. M. Rashad
Eman Abdelaziz
Ahmed Ramadan
Ahmed A. Ali
author_sort Marwa Zakaria
collection DOAJ
description Abstract Background Febrile neutropenia (FN) is a common treatment-related complication in pediatric cancer patients with substantial morbidities and mortalities. Previous studies reported that neutrophil CD64 (n CD64) had higher diagnostic accuracy for infection with high sensitivity and specificity in neonates, pediatrics and adult patients. We aimed to evaluate the usefulness of neutrophil CD64 expression as an early diagnostic marker of sepsis in children with cancer during episodes of FN. Methods a case control study was conducted on 100 children (50 patients with hematological malignancies and febrile neutropenia, 25 patients with hematological malignancies without febrile neutropenia and 25 apparently healthy children as a control group). Routine laboratory investigations including blood culture were done in patients with cancer according to our local standards. Procalcitonin level and Neutrophil CD64 expression by flowcytometry were measured for all study participants. Results n CD64 expression was significantly higher in patients with cancer and FN compared to other groups (p > 0.001). At a cutoff value of ≥ 17.82%, serum n CD64 had 94% sensitivity and 72% specificity. n CD64 expression level was negatively correlated to absolute neutrophil count (ANC) during episode of FN (r= (-0.359, p = 0.01). A positive correlation was found between nCD64 expression and both of CRP and procalcitonin. Blood culture was positive in 54% in patients with cancer and FN. The most common isolated organism was Kllibselia pneumonia. Among patients with cancer and FN, n CD64 expression level was significantly higher in patients with positive blood culture compared to those with negative cultures. Conclusion Neutrophil CD64 expression seems to be a reliable marker in early detection of sepsis during episodes of febrile neutropenia in children with hematological malignancies.
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spelling doaj-art-04b0a4d83f4540b587136fb76e048e932025-08-20T03:10:32ZengBMCItalian Journal of Pediatrics1824-72882025-05-015111810.1186/s13052-025-01979-9Neutrophil CD64 can be an early predictor for sepsis during febrile neutropenic episodes in children with cancer: a case control studyMarwa Zakaria0Nehad Karam1Tamer Hassan2Nahla Zidan3Asmaa Abdelsalam4Raghdaa A. Ramadan5Marwa L. M. Rashad6Eman Abdelaziz7Ahmed Ramadan8Ahmed A. Ali9Pediatric Department, Faculty of Medicine, Zagazig UniversityPediatric Department, Faculty of Medicine, Zagazig UniversityPediatric Department, Faculty of Medicine, Zagazig UniversityClinical Pathology Department, Faculty of Medicine, Zagazig UniversityPediatric Department, Faculty of Medicine, Zagazig UniversityMicrobiology Department, Faculty of Medicine, Zagazig UniversityPediatric Department, Faculty of Medicine, Zagazig UniversityClinical Pathology Department, Faculty of Medicine, Zagazig UniversityPediatric Department, Faculty of Medicine, Zagazig UniversityPediatric Department, Faculty of Medicine, Zagazig UniversityAbstract Background Febrile neutropenia (FN) is a common treatment-related complication in pediatric cancer patients with substantial morbidities and mortalities. Previous studies reported that neutrophil CD64 (n CD64) had higher diagnostic accuracy for infection with high sensitivity and specificity in neonates, pediatrics and adult patients. We aimed to evaluate the usefulness of neutrophil CD64 expression as an early diagnostic marker of sepsis in children with cancer during episodes of FN. Methods a case control study was conducted on 100 children (50 patients with hematological malignancies and febrile neutropenia, 25 patients with hematological malignancies without febrile neutropenia and 25 apparently healthy children as a control group). Routine laboratory investigations including blood culture were done in patients with cancer according to our local standards. Procalcitonin level and Neutrophil CD64 expression by flowcytometry were measured for all study participants. Results n CD64 expression was significantly higher in patients with cancer and FN compared to other groups (p > 0.001). At a cutoff value of ≥ 17.82%, serum n CD64 had 94% sensitivity and 72% specificity. n CD64 expression level was negatively correlated to absolute neutrophil count (ANC) during episode of FN (r= (-0.359, p = 0.01). A positive correlation was found between nCD64 expression and both of CRP and procalcitonin. Blood culture was positive in 54% in patients with cancer and FN. The most common isolated organism was Kllibselia pneumonia. Among patients with cancer and FN, n CD64 expression level was significantly higher in patients with positive blood culture compared to those with negative cultures. Conclusion Neutrophil CD64 expression seems to be a reliable marker in early detection of sepsis during episodes of febrile neutropenia in children with hematological malignancies.https://doi.org/10.1186/s13052-025-01979-9Febrile neutropeniaNeutrophil CD64CancerSepsis
spellingShingle Marwa Zakaria
Nehad Karam
Tamer Hassan
Nahla Zidan
Asmaa Abdelsalam
Raghdaa A. Ramadan
Marwa L. M. Rashad
Eman Abdelaziz
Ahmed Ramadan
Ahmed A. Ali
Neutrophil CD64 can be an early predictor for sepsis during febrile neutropenic episodes in children with cancer: a case control study
Italian Journal of Pediatrics
Febrile neutropenia
Neutrophil CD64
Cancer
Sepsis
title Neutrophil CD64 can be an early predictor for sepsis during febrile neutropenic episodes in children with cancer: a case control study
title_full Neutrophil CD64 can be an early predictor for sepsis during febrile neutropenic episodes in children with cancer: a case control study
title_fullStr Neutrophil CD64 can be an early predictor for sepsis during febrile neutropenic episodes in children with cancer: a case control study
title_full_unstemmed Neutrophil CD64 can be an early predictor for sepsis during febrile neutropenic episodes in children with cancer: a case control study
title_short Neutrophil CD64 can be an early predictor for sepsis during febrile neutropenic episodes in children with cancer: a case control study
title_sort neutrophil cd64 can be an early predictor for sepsis during febrile neutropenic episodes in children with cancer a case control study
topic Febrile neutropenia
Neutrophil CD64
Cancer
Sepsis
url https://doi.org/10.1186/s13052-025-01979-9
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