ENDOTOXEMIA IN FEBRILE PATIENTS WITH HEMATOLOGICAL MALIGNANCIES - RELATIONSHIP OF TYPE OF BACTEREMIA, CLINICAL FINDINGS AND SERUM CYTOKINE PATTERN

The relation between gram-negative bacteremia, endotoxemia and cytokin emia in patients with hematological malignancies was studied. Serum en dotoxin and cytokines (tumor necrosis factor-alpha, interleukin-1 rece ptor antagonist, interferon-gamma, interleukin-6 and interleukin-10) w ere determined in 24 patients with hematological malignancies, Patient s were included at start of fever (n=18) or during a temperature peak during continuous fever (n=6; time=0). Blood was drawn for cultures at time of inclusion. Additional samples were obtained and grouped in tw o time intervals (1-5 h and 6-12 h after inclusion). Endotoxin was det ected in eight patients. Endotoxemia was more common among patients wi th bacteremia than among non-bacteremic patients (7/12 versus 1/12; p <0.05). All studied cytokines showed a tendency to higher mean values at time 0 in patients with endotoxemia than in patients without endoto xemia. Significantly higher mean endotoxin values were seen at time 1- 5 h in patients with gram-negative bacteremia (n=6) than in patients w ithout gram-negative bacteremia, and at time 0 in patients with chills (n=6) compared to those without chills.