Abstract • 60

Fever periods during chemotherapy-related neutropenia are serious complications in the treatment of cancer. Due to a high infection-related mortality, the standard therapy include hospitalisation and empiric treatment with broad-spectrum antibiotics intravenously for at least 5 days. With conventional parameters such as physical examination, leukocyte count and C-reactive protein it is hard to distinguish patients at low risk for sepsis among all patients with fever and neutropenia. For this reason we investigated the diagnostic value of interleukin-8 (IL-8). In a prospective study 72 consecutive febrile periods (in 53 patients) were studied for IL-8 plasma concentrations. Blood was collected at presentation with fever and neutropenia. Proven sepsis was defined as blood culture positive sepsis or clinically defined sepsis. All other febrile episodes were included in the group non-proven sepsis. IL-8 plasma values were measured with an Immulite analyser (DPC, Apeldoorn, The Netherlands). Proven sepsis was found in 25% of the febrile episodes. IL-8 plasma levels were significantly higher in febrile episodes with proven sepsis (204 ng/L; range:44-17500) compared to febrile episodes with non-proven sepsis (81 ng/L; range:5-4879) (p=0.032). If a cut off value with 100% sensitivity for sepsis was chosen, we were able to define a group of low risk for sepsis of 27%. Early discharge of these low risk patients will result in better quality of life and health care cost reduction.