PERBEDAAN KADAR INTERLEUKIN-8 PADA INFEKSI DAN NONINFEKSI BAKTERI PADA LEUKEMIA ANAK DENGAN DEMAM NEUTROPENIA

Abstract

Background. Leukemia patients with chemotherapy-related neutropenia are usually have neutropenia fever, who need hospitalization and intravenous broad-spectrum antibiotics regimens. Early diagnosis of bacteremia/sepsis in children with febrile neutropenia remains difficult due to non-specific clinical and laboratory signs of infection. IL-8 is a proinflammatory cytokines produced by neutrophyl, macrofage, and endothelial cells’ wall, and suspected as a marker of early bacterial infection. Aim: Proving the difference between IL-8 level on bacterial and non bacterial infection on leukemia children with febrile neutropeni. Methods An analytical observational with prospective cross sectional study. A group of leukemia children with febrile neutropeni was investigated who was fulfill inclusion criteria with subjects were 20 episodes febrile neutropenia in Kariadi Hospital on January-July 2011. Subject was chosen with consecutive sampling methode, was noted clinical data, blood culture and IL-8. The determination of bacterial infection was based on blood culture which were performed in microbiology laboratory in Kariadi Hospital and IL-8 serum levels were measured with Enzyme-linked immunosorbent assay (Elisa) methode in GAKI FK Undip laboratory. Analysis using nonparametric Mann-Whitney test. Results: Subjects, 20 episodes of febrile neutropenia from 19 cases, with aged between 6 months and 13 years, 65% boys, 95% ALL and 5% AML. The result was 12 episodes are bacteri (+) group : 6 subjects gram - bacteria, 6 subjects gram- bacteria and 8 episodes with no bacteria. The Median IL-8 plasma was most high on gram – bacteriemia, for 2.044,75 (795,82-2.088,55), next was gram+, 244,20 (148,88-795,82), and for nonbacteremia: 67,65 (8,9-111,88) pg/ml (p<0,001). Conclusion Median IL-8 level on bacteriemia was higher than nonbacteriemia, and median IL-8 level on bacteriemia on bacteriemia gram – was higher than gram +; statistically significant. Keywords: IL-8, febrile neutropenia, leukemia