TY - JOUR T1 - KEMOTERAPİ SONRASI FEBRİL NÖTROPENİ ATAĞI GEÇİREN PEDİATRİK ONKOLOJİ HASTALARINDA NÖTROFİL/LENFOSİT ORANI, PLATELET/LENFOSİT ORANI, SİSTEMİK İMMÜN-İNFLAMASYON İNDEKSİ VE ORTALAMA TROMBOSİT HACMİYLE İLİŞKİLİ İNDEKSLERİN DEĞERLENDİRİLMESİ TT - PROGNOSTIC VALUE OF NEUTROPHIL/LYMPHOCYTE RATIO, PLATELET/LYMPHOCYTE RATIO, SYSTEMIC IMMUNE-INFLAMMATION INDEX, AND MEAN PLATELET VOLUME-RELATED INDICES IN PEDIATRIC ONCOLOGY PATIENTS EXPERIENCING FEBRILE NEUTROPENIA EPISODES AFTER CHEMOTHERAPY AU - Keskin Aktan, Arzu AU - Eker, İbrahim AU - Üstün, Fatma Nur AU - Karaman, Ali İhsan AU - Çağıl, Ahmet Eren AU - Çam, Buket AU - Sökmen, Ece Merve AU - Bağcı, Nilüfer AU - Kepel, Tuana PY - 2025 DA - October Y2 - 2025 DO - 10.18229/kocatepetip.1477957 JF - Kocatepe Tıp Dergisi JO - KTD PB - Afyonkarahisar Sağlık Bilimleri Üniversitesi WT - DergiPark SN - 3061-9904 SP - 286 EP - 294 VL - 26 IS - 4 LA - tr AB - AMAÇ: Febril nötropeni (FN), miyelosüpresif kemoterapinin enyaygın görülen komplikasyonlarından biridir ve önemli orandahospitalizasyon ve mortalite nedenidir. Çalışmada kemoterapialan pediatrik onkoloji hastalarında görülen FN atağında nötrofil/lenfosit oranı (NLR), platelet/lenfosit oranı (PLR), sistemikimmün-inflamasyon indeksi (SII) ve ortalama trombosit hacmiyle(MPV) ilişkili hematolojik indekslerin değerlendirilmesiamaçlandı.GEREÇ VE YÖNTEM: Tek merkezli, retrospektif kohort çalışmada,0-16 yaş aralığında kanser nedeniyle kemoterapi alanhastalar (n = 98), kemoterapiden sonraki bir ay içinde FN atağıolanlar (n = 40) ve olmayanlar (n = 58) şeklinde iki gruba ayrıldı.Hastaların sosyodemografik özellikleri (yaş, cinsiyet), temelklinik özellikleri (geliş nedeni, öykü, tanı, antibiyotik kullanımı,komorbidite vb) ve hematolojik bulgularına ait veriler kaydedildi.Hastaların mevcut hemogram verileri kullanılarak NLR, PLR,SII, MPV/platelet oranı (MPV/PLT), MPV/C-reaktif protein oranı(MPV/CRP) ve MPV/prokalsitonin oranı (MPV/PCT) hesaplandı.Grupları karşılaştırmak için ki-kare, bağımsız örneklem t testiveya Mann-Whitney U testi kullanıldı. Ayrıca lojistik regresyonve alıcı çalışma karakteristikleri (ROC) analizleri yapıldı. P < 0,05düzeyi istatistiksel olarak anlamlı kabul edildi.BULGULAR: FN grubunda NLR ve SII anlamlı olarak düşük, PLRise yüksek bulundu. MPV ilişkili indekslerden MPV/PLT, FN grubundaanlamlı olarak yüksek iken MPV/CRP ve MPV/PCT ise düşüktü.FN için potansiyel prediktif faktörler olarak tespit edilenyaş, CRP, PLR ve MPV/PCT ile oluşturulan çok değişkenli lojistikregresyon modelinde sadece MPV/PCT’nin FN için bağımsızprediktif faktör olduğu bulundu. Ayrıca 57,33 optimal kesmedeğeri için MPV/PCT’nin % 89,7 duyarlılık ve %100 özgüllüğesahip olduğu görüldü.SONUÇ: Araştırdığımız indeksler arasında MPV/PCT’nin, pediatrikonkoloji hastalarında kemoterapi sonrasında görülebilen FNatağını yordayan başlıca değişken olduğu söylenebilir. KW - Febril nötropeni KW - Kanser KW - Kemoterapi KW - Ortalama trombosit hacmi N2 - OBJECTIVE: Febrile neutropenia (FN) is one of the most commoncomplications of myelosuppressive chemotherapy anda significant cause of hospitalization and mortality. The studyaimed to evaluate hematological indices, including neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), systemicimmune-inflammation index (SII), and mean platelet volume(MPV) related indices in the FN episodes in pediatric oncologypatients receiving chemotherapy.MATERIAL AND METHODS: In a single-center, retrospectivecohort study, patients aged 0-16 years receiving chemotherapyfor cancer (n = 98) were divided into two groups: those whoexperienced an FN episode within one month following chemotherapy(n = 40) and those who did not (n = 58). Socio-demographiccharacteristics (age, gender), basic clinical features(reason for admission, history, diagnosis, antibiotic use, comorbidities,etc.), and hematologic findings data were recorded. Basedon the patients' current hemogram data, NLR, PLR, SII, MPV/platelet ratio (MPV/PLT), MPV/C-reactive protein ratio (MPV/CRP), and MPV/procalcitonin ratio (MPV/PCT) were calculated.Chi-square, independent sample t-test, or Mann-Whitney U-testwere used to compare groups. Logistic regression and receiveroperating characteristics (ROC) analyses were also conducted.A level of P < 0.05 was considered statistically significant.RESULTS: In the FN group, NLR and SII were significantly lowerwhereas PLR was significantly higher. Among the MPV relatedindices, MPV/PLT was significantly higher in the FN group, whereasMPV/CRP and MPV/PCT were significantly lower. In themultivariate logistic regression model constructed with age,CRP, PLR, and MPV/PCT as potential predictive factors for FN,only MPV/PCT was identified as an independent predictive factorfor FN. Additionally, it was observed that MPV/PCT had asensitivity of 89.7% and a specificity of 100% for FN at the optimalcut-off value of 57.33.CONCLUSIONS: It can be said that among the indices we investigated,the MPV/PCT is the primary variable predicting FN episodesthat may occur in pediatric oncology patients followingchemotherapy. CR - 1. Hughes WT, Armstrong D, Bodey GP, et al. 2002 guidelines for the use of antimicrobial agents in neutropenic patients with cancer. Clin Infect Dis. 2002;34(6):730–51. CR - 2. Freifeld AG, Bow EJ, Sepkowitz KA, et al. Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the Infectious Diseases Society of America. Clin Infect Dis. 2011;52(4):e56–93. CR - 3. Masaoka T. 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AACC guidance document on the clinical use of procalcitonin. J Appl Lab Med. 2023;8(3):598–634. UR - https://doi.org/10.18229/kocatepetip.1477957 L1 - https://dergipark.org.tr/en/download/article-file/3903684 ER -