SOLUBLE CD14 AS A BIOMARKER OF SEPSIS AND ITS RELATION TO BLOOD CULTURES IN FEBRILE NEUTROPENIC ACUTE MYELOID LEUKEMIA PATIENTS RECEIVING CHEMOTHERAPY

• The incidence of acute leukemia in Egypt according to the National Population-Based Cancer Registry Program is about 3 cases per 100 000 population.
• Acute leukemia is classified according to WHO classification which incorporates clinical, prognostic, morphologic, immunophenotypic, and genetic data.
• Manifestations of acute leukemia can result from constitutional symptoms, bone marrow failure , infilteration of other organs and of leukocytosis.
• Acute leukemia patients are more prone to infections due to several factors including neutropenia, disruption of mucosal barriers and administration of immune suppressive drugs.
• The most popular tool used to predict the risk of complications associated with a febrile neutropenia is the Multinational Association of Supportive Care in Cancer (MASCC) score.
• The use of standard culture techniques for the detection and isolation of pathogenic organisms from a sterile body fluid specimen is still considered the “gold standard” for the diagnosis of infection and sepsis.
• Bacterial infections are commonly caused by six main etiologies: three Gram-negative (E. coli, Klebsiella sp and Pseudomonas aeruginosa) and three Gram-positive (S. aureus, S. epidermidis and S. Viridans).
• Presepsin is a new sepsis marker that show a potential as an early marker of sepsis recognition, for antimi‌crobial therapy monitoring and as a prognostic marker.
• Presepsin (sCD14-ST) is a peptide sized 13 kDa that is generated by proteolytic cleav‌age of soluble forms of CD14 cluster (sCD14).
• The major CRP drawback in sepsis lies in its lack of specificity.