Purpose: To assess the efficacy of an IL-6 blockade with tocilizumab on treatment outcome of severe sepsis/septic shock in children with febrile neutropenia. Methods: We performed a retrospective study of febrile neutropenic patients younger than 18 years old who developed severe sepsis/septic shock at a single medical center between November 2022 and October 2023. Results: Seven patients with febrile neutropenia complicated with severe sepsis/septic shock were identified. Four of seven patients received tocilizumab in addition to standard of care. The median IL-6 level before administration of tocilizumab was 14,147 pg/mL (range: 672–30,509 pg/mL). All four patients successfully recovered from severe sepsis/septic shock. Three of seven patients received standard of care without tocilizumab. IL-6 levels were checked intwo2 patients, with a median of 1514.5 (range: 838–2191). Only one of three (33%) patients without tocilizumab therapy made a full recovery from severe sepsis/septic shock. The mortality rate was higher in patients without tocilizumab therapy compared to patients with tocilizumab therapy (67% vs. 0%). Conclusions: Administration of tocilizumab reduced mortality of severe sepsis/septic shock in children with febrile neutropenia. However, it warrants confirmation with a larger number of patients and a longer follow-up.
目的：评估使用托珠单抗进行IL-6阻断对发热性中性粒细胞减少症患儿严重脓毒症/脓毒性休克治疗结局的疗效。方法：我们对2022年11月至2023年10月期间在单一医疗中心发生严重脓毒症/脓毒性休克的18岁以下发热性中性粒细胞减少症患者进行了回顾性研究。结果：共纳入7例并发严重脓毒症/脓毒性休克的发热性中性粒细胞减少症患者。其中4例患者在标准治疗基础上接受了托珠单抗治疗，给药前IL-6水平中位数为14,147 pg/mL（范围：672–30,509 pg/mL）。这4例患者均成功从严重脓毒症/脓毒性休克中康复。其余3例患者仅接受标准治疗（未使用托珠单抗），其中2例检测的IL-6水平中位数为1514.5 pg/mL（范围：838–2191）。未接受托珠单抗治疗的3例患者中仅有1例（33%）从严重脓毒症/脓毒性休克中完全康复。与接受托珠单抗治疗的患者相比，未接受该治疗的患者死亡率更高（67% vs. 0%）。结论：托珠单抗治疗可降低发热性中性粒细胞减少症患儿严重脓毒症/脓毒性休克的死亡率，但这一结论仍需通过更大样本量和更长期随访研究加以验证。
肿瘤(癌症)患者之家