Neutropenia febril como marcador de sepsis en patologías cancerígenas
Resumen
La neutropenia febril en pacientes oncológicos, es definida por la presencia de fiebre junto con un recuento absoluto de neutrófilos bajo, representa una grave complicación durante la quimioterapia, aumentando el riesgo de infecciones bacterianas graves, como es la sepsis. Además de los biomarcadores tradicionales, como es la proteína C reactiva y la proteína precursora de la calcitonina, se están investigando nuevas moléculas, como las angiopoyetinas, específicamente angiopoyetinas-1 y angiopoyetinas-2, y los factores relacionados, como son el factor de crecimiento vascular endotelial, para mejorar la predicción y el manejo de la sepsis en esta población vulnerable. Estudios recientes han resaltado la importancia de angiopoyetinas-2, cuyos niveles elevados y la relación angiopoyetinas-2 y angiopoyetinas-1 se han asociado con la predicción precoz de la sepsis en pacientes con neutropenia febril, además de correlacionarse con la gravedad de la sepsis y la progresión al shock séptico. Paralelamente, el factor de crecimiento vascular endotelial A ha emergido como un indicador de la progresión de la sepsis, sugiriendo su potencial para estratificar el riesgo y guiar decisiones terapéuticas. La integración de estos biomarcadores en la práctica clínica mejoraría la identificación temprana de pacientes en riesgo de sepsis y permitir intervenciones personalizadas, pero se requieren investigaciones adicionales para validar su utilidad clínica y establecer protocolos de manejo basados en ellos. Estos avances en biomarcadores prometen no solo mejorar los resultados clínicos y la supervivencia de pacientes con neutropenia febril, sino también transformar el abordaje de la sepsis en esta población vulnerable.
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Derechos de autor 2024 Nicolas Teatino-Rubio, Ana Maria Uribe-Molina
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