Serum interleukin-1 and tumor necrosis factor activities in febrile children with acute leukemia

In order to determine whether a relationship exists between levels of serum interleukin-1 (IL-1) and tumor necrosis factor (TNF) and the incidence of fever in malignant disease and infection, IL-1 and TNF levels in 60 children with acute leukemia, 18 children with bacterial infection, and 10 children with viral infection were compared with those of 20 healthy children. IL-1 levels greater than 100 pg/ml were seen in two febrile leukemic patients and six bacteria-infected patients, and the bacteria-infected group as a whole had IL-1 levels significantly higher than those of healthy children (p < 0.05). TNF levels greater than 50 pg/ml were noted in six febrile leukemic patients and two bacteria-infected patients (both of whom were complicated by septic shock). No single group showed significantly higher levels when compared to healthy children. All patients showing high IL-1 or TNF levels had fevers at the time of diagnosis. These findings suggest that fever in bacterial infection is associated with the production of IL-1 but not TNF (except in cases of septic shock), whereas fever in acute leukemia may be associated with the production of either IL-1 or TNF. Monitoring patients with acute leukemia for IL-1 and TNF levels throughout the clinical course of disease may help clarify the causes of febrile episodes.