Texas — Targeted Issue
Diagnostic Signatures in Febrile Infants
Sept. 1, 2007 - June 30, 2009


Southwestern Medical Center at Dallas (later moved to Nationwide Children's Ohio)
Principal Investigator(s)
Award Amount


HRSA Region


EMSC Region

Red River

HPP Region





Name Roles Agency Mailing Address Office Phone Email
Octavio Ramilo, MD
  • Principal Investigator
Southwestern Medical Center at Dallas (later moved to Nationwide Children's Ohio)


Title Published Author Abstract Publication PMID
Predictive value of interleukin-5 and monocyte chemotactic protein-1 for bacteremia in children with febrile neutropenia 2012 Aquino VM, Cost C, Gomez A, Bowers DC, Ramilo O, Ahmad N, Winick N, Leavey PJ A variety of clinical and laboratory parameters have been used to predict bacteremia. We hypothesize that the generation of a cytokine profile could be used to identify patients at higher risk of bacteremia at the time of presentation with febrile neutropenia. We prospectively evaluated children with cancer who presented with an episode of febrile neutropenia. A multiplexed flow cytometric assay was performed which measured 15 cytokines and chemokines obtained before the initiation of antibiotics. Fifty-eight episodes of chemotherapy-induced febrile neutropenia were included in this study during which 4 patients (7%) had bacteremia. An interleukin-5 level of >8 pg/dL had a sensitivity of 67% and a specificity of 96% to predict bacteremia. An monocyte chemotactic protein-1 level >1650 pg/dL had a sensitivity of 80% and a specificity of 82% to predict bacteremia. Erythrocyte sedimentation rate, C-reactive protein, protein C, and other cytokines/chemokines were not predictive of bacteremia. Elevations of interleukin-5 and monocyte chemotactic protein-1 are predictive of bacteremia in children with cancer who have febrile neutropenia. Prospective studies should be undertaken to determine whether these parameters retain predictive value in a larger series of patients and can select children for outpatient management or early discharge. J Pediatr Hematol Oncol 22584776