D-dimer is a strong predictor of mortality in paediatric hematological-oncological patients with severe infections

Area of Science:

• Pediatric Hematology Oncology
• Infectious Diseases
• Biomarker Discovery

Background:

• Children with hematological malignancies are at high risk for severe infections.
• Early identification of infection severity and mortality risk is critical for timely intervention.

Purpose of the Study:

• To evaluate the prognostic value of inflammatory and thrombotic biomarkers in predicting severe infections and mortality in pediatric hematological malignancy patients.
• To assess C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), interleukin-10 (IL-10), and D-dimer levels.

Main Methods:

• A retrospective observational study was conducted from October 2018 to December 2020.
• Clinical data and blood samples were collected from pediatric patients with hematological malignancies experiencing febrile illnesses.
• Biomarker levels (D-dimer, Fibrinogen, PT, APTT, CRP, PCT, cytokines) were analyzed within 24 hours of fever onset.

Main Results:

• Biomarker levels (CRP, PCT, IL-6, IL-10, D-dimer) increased with infection severity.
• D-dimer demonstrated the highest accuracy (AUC 0.930) in predicting mortality in severe infections.
• Combined IL-6 and D-dimer analysis improved sepsis prognosis accuracy; lower 60-day survival was observed with D-dimer > 1.91 mg/L.

Conclusions:

• D-dimer is a reliable biomarker for predicting mortality in children with hematological malignancies and severe infections.
• Elevated D-dimer levels indicate a poorer prognosis and higher risk of mortality.