A moderate but statistically significant increase in CRP (P < 0.01)

and PCT (P = 0.01) was seen from the time of febrile neutropenia to 1–2 days later (Table 2). Moderate but statistically significant (P < 0.01) increases in the complement activation products C3bc and TCC were detected from the time of febrile neutropenia to 1–2 days later (Table 2), consistent with a moderate in vivo activation of complement during this period. Five patients were deficient for MBL (<60 μg/l), and five other patients had decreased values for MBL (219–326 μg/l), a prevalence of MBL variants that is the normal finding for a Caucasian population [8]. We found a modest but statistically significant (P < 0.05) change in 10 of the 17 cytokines measured (Table 2). Notably, three of them showed BAY 80-6946 a decline during the period, significant only for IL-5, though. The others showed very modest increases, indicating a lack buy MK-8669 of cytokine storm in these patients. IL-6, IL-8, IL-10, INFγ and TNFα correlated positively with each other both at the onset of febrile neutropenia, 1–2 days later and regarding the increases in the values of the cytokines. Unfortunately, there were too few patients with low MBL values in this population to make a statistical statement concerning a correlation with the cytokine pattern. The comparison of the patients who received tobramycin once daily

with those who received the antibiotic three times daily is presented in Table 3. We found a statistically significant higher increase

in the once-daily group compared with the three-times-daily group for PCT and for the following cytokines: IL-1β, IL-4, IL-6, IL-10, IL-12, GM-CSF, INFγ and TNFα (P < 0.05). The profiles of PCT, complement activation factors and cytokines suggested a mild inflammatory response in these lymphoma patients [16] undergoing high-dose chemotherapy with autologous stem cell support. The benign clinical course of the patients was in accordance with these findings. However, we were not able to make a conclusion as to our hypothesis. The results reflect only the situation in patients with a benign course of febrile neutropenia, and they say nothing about the inflammatory response in patients with a Gram-negative sepsis or a more Casein kinase 1 severe course of febrile neutropenia. The CRP values showed a wide non-specific variation, reflecting neither the non-complicated clinical course nor the relatively low PCT and cytokine levels. Fifty of the 55 patients with paired blood samples had PCT values <0.5 μg/l, suggesting no bacterial infection [4]. As reference intervals have not been established for cytokines, the results in Tables 2 and 3 must stand on their own. Statistically significant median concentration increases were seen from the onset of febrile neutropenia to the drawing of the second sample for the cytokines, IL-1β, IL-4, IL-6, IL-7, IL-8, G-CSF, GM-CSF, INFγ and TNFα. There was on the other hand a statistically significant decrease in the IL-5 concentration.