Use of a novel measuring technique for the erythrocyte sedimentation rate--a pilot study in patients with neutropenia and fever.

In the present study a new technique for measuring the erythrocyte sedimentation rate (ESR) is clinically evaluated. This technique extends the measuring range above that of the traditional ESR by calculating the sedimentation (S) at 60 minutes from data collected between 18 and 24 minutes. Measurement of ESR, S and C-reactive protein (CRP) was performed prospectively three times a week in 25 patients developing 30 fever episodes following chemotherapy for a hematological malignancy. A good correlation was obtained between S and ESR values up to 90 mm (r = 0.98; p < 0.0001). The use of S may allow the clinician to follow an infectious or inflammatory process more accurately than with ESR. During neutropenia a rise in S preceded fever in all episodes were two samples were obtained before start of fever (n = 13). Changes in CRP and S values showed the same pattern in 11 episodes, in 12 CRP preceded S and in 7 episodes there was no correlation between the results. CRP, opposed to S, discriminated between bacteremias and blood culture negative episodes (p < 0.05) in samples obtained during the first 72 hours after start of fever. In patients with fever during neutropenia determination of S does not offer any clear advantage to CRP.