Morbidity and mortality due to
infections remain serious problems in pediatric oncology patients receiving
chemotherapy. Association of
mannose-binding lectin (MBL) levels with an increased risk for
infection in previous studies was contradictory. The aim of this study was to determine whether
MBL deficiency is associated with the risk of
infections in pediatric oncology patients. Before the start of
chemotherapy a blood sample was taken from 75 patients with
acute lymphoblastic leukemia and MBL serum concentration was measured using a commercially
enzyme-linked
immunosorbent assay kit. Twenty patients had concentrations under 1000 µg/L, defining
MBL deficiency and the remaining 55 patients had concentrations >1000 µg/L. Ten patients suffered from more than 1 episode of severe
infection. Sixty-five percent of patients with MBL below 1000 µg/mL suffered from 2 or more episodes of
infections (3 of 16 individuals with 1 severe
infection; 10 of 16 with 2 and 3 of 16 with 3), in contrast to only 29 of 55 (52%) patients with MBL above 1000 µg/mL (19 of 27 individuals with 1 severe
infection and 10 of 27 with 2). The difference between 2 groups was significant (P<0.001). The results of this study indicate that low MBL serum levels (<1000 µg/L) identify pediatric
cancer patients at increased risk for
infections.