H-ficolin serum concentration and susceptibility to fever and neutropenia in paediatric cancer patients

• Published in: Clinical and experimental immunology 2009-07, Vol.157 (1), p.83-89
• Main Authors: Schlapbach, L.J, Aebi, C, Hansen, A.G, Hirt, A, Jensenius, J.C, Ammann, R.A
• Format: Article
• Language: English
• Subjects: Adolescent; Analytical, structural and metabolic biochemistry; bacteraemia; Bacteremia; Bacterial Infections - blood; Biological and medical sciences; Biomarkers - blood; cancer; Child; Child, Preschool; Disease Susceptibility; Female; Fever - blood; fever and neutropenia; Fluoroimmunoassay; Fundamental and applied biological sciences. Psychology; Glycoproteins - blood; H-ficolin; Hematologic and hematopoietic diseases; Humans; immunity; innate immunity; Lectins - blood; Male; Medical sciences; neoplasms; Neoplasms - blood; Neutropenia - blood; Other diseases. Hematologic involvement in other diseases; Risk Factors; Statistics, Nonparametric; Translational Studies
• ISSN: 0009-9104; 1365-2249
• DOI: 10.1111/j.1365-2249.2009.03957.x

H-ficolin (Hakata antigen, ficolin-3) activates the lectin pathway of complement similar to mannose-binding lectin. However, its impact on susceptibility to infection is currently unknown. This study investigated whether the serum concentration of H-ficolin at diagnosis is associated with fever and neutropenia (FN) in paediatric cancer patients. H-ficolin was measured by time-resolved immunofluorometric assay in serum taken at cancer diagnosis from 94 children treated with chemotherapy. The association of FN episodes with H-ficolin serum concentration was analysed by multivariate Poisson regression. Median concentration of H-ficolin in serum was 26 mg/l (range 6-83). Seven (7%) children had low H-ficolin (< 14 mg/l). During a cumulative chemotherapy exposure time of 82 years, 177 FN episodes were recorded, 35 (20%) of them with bacteraemia. Children with low H-ficolin had a significantly increased risk to develop FN [relative risk (RR) 2·24; 95% confidence interval (CI) 1·38-3·65; P = 0·004], resulting in prolonged duration of hospitalization and of intravenous anti-microbial therapy. Bacteraemia occurred more frequently in children with low H-ficolin (RR 2·82; CI 1·02-7·76; P = 0·045). In conclusion, low concentration of H-ficolin was associated with an increased risk of FN, particularly FN with bacteraemia, in children treated with chemotherapy for cancer. Low H-ficolin thus represents a novel risk factor for chemotherapy-related infections.