Details

Autor(en) / Beteiligte

• Jimeno, Antonio
• García‐Velasco, Adelaida
• del Val, Olga
• González‐Billalabeitia, Enrique
• Hernando, Susana
• Hernández, Rosario
• Sánchez‐Muñoz, Alfonso
• López‐Martín, Ana
• Durán, Ignacio
• Robles, Luis
• Cortés‐Funes, Hernán
• Paz‐Ares, Luis

Titel

Assessment of procalcitonin as a diagnostic and prognostic marker in patients with solid tumors and febrile neutropenia

Ist Teil von

• Cancer, 2004-06, Vol.100 (11), p.2462-2469

Ort / Verlag

Hoboken: Wiley Subscription Services, Inc., A Wiley Company

Erscheinungsjahr

2004

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• BACKGROUND Cancer patients with fever and neutropenia currently are assessed on clinical grounds only. The current study prospectively evaluated the efficacy of baseline procalcitonin (PCT) in the detection of bacteremia and in the prediction of outcome in patients with solid tumors and febrile neutropenia. METHODS PCT levels were determined at baseline and every 48 hours in 104 patients undergoing chemotherapy who developed fever (axillary temperature > 38 °C on 2 occasions or > 38.3 °C in a single record) and neutropenia (absolute neutrophil count < 500 cells/μL). RESULTS The median baseline PCT values were significantly higher in patients who had microbiologically documented infections (1.24 ng/mL) compared with patients who had clinically documented infections (0.27 ng/mL) or fever of unknown origin (0.21 ng/mL; P < 0.01). Accordingly, a PCT cut‐off value of 0.5 ng/mL was reached more frequently in patients who had microbiologically documented infections compared with patients who had clinically documented infections or fever of unknown origin (66.7% vs. 13.4%, respectively; P < 0.001). Furthermore, this threshold also was associated with an increased likelihood of treatment failure (70.0% vs. 14.9%; P < 0.001). All 4 septic patients and all 5 patients who ultimately died presented PCT values 5‐fold to 10‐fold greater than the median values. Clinical evaluation in combination with baseline PCT assessment appeared to improve clinical risk evaluation alone. CONCLUSIONS Baseline PCT levels were higher in patients who had febrile neutropenia with bacteremia compared with patients who had clinical infections or fever of unknown origin. PCT helped to identify patients who had microbiologic infections and patients who were at high risk of treatment failure, and PCT may constitute a complementary tool in the initial assessment of such patients. Cancer 2004. © 2004 American Cancer Society. Baseline procalcitonin levels are higher in febrile neutropenic patients who have bacteremia compared with patients who have a clinical infection or fever of unknown origin. Combined clinical and procalcitonin assessment may improve clinical risk evaluation alone.