Evaluation of procalcitonin for diagnostics of septic complications in hematological patients and stem cell transplant recipients

摘要

Background:Sepsisandsepticshockareamongthemostdangerouscomplicationsinpatientsreceivingconventionalchemotherapy,hematopoieticstemcelltransplantation(HSCT),andimmunosuppressivetreatmentofgraft-versus-hostdisease(GVHD).Thesediagnosesshouldusuallyhaveadditionalconfirmationwithspecificbiomarkers,suchasprocalcitonin(PCT).Aim:TodetectthesignificanceandefficacyofPCTinthediagnosisofsepsisamonghematologicalpatients.Patientsandmethods:Twenty-fivepatientsreceivingchemotherapy(n=13),HSCT(n=6),andGVHDtreatment(n=6)withdiagnosedsepsiswereenrolledintothestudy.Atthetimeoftheinfection68%ofthemhadneutropenia,and88%fever.Diagnosisofsepsiswasprovidedbymicrobiologicalassay,quantitativeC-reactiveprotein(100%positive),andadditionallyverifiedbyasemi-quantitativePCT-test(declaredpositiveatlevelsgreaterthan2.0ng/ml).Microbiologicaldetectionwasachievedin72%ofcases(n=18).Results:ThemedianofPCTwas2.0ng/ml.PCTconcentrationswere10.0ng/mlin52%,2.0ng/mlin24%,0.5ng/mlin8%,and0.5ng/mlin16%ofcases.AmongthepatientswhoweresepsispositivePCTwasobservedin75%,withseveresepsisin72.7%,andwithsepticshockin80%ofcases.In28%ofpatientsPCTwas2.0ng/mlwhilethemicrobiologywasnegative.ThreepatientswithoutfeverandpositivemicrobiologyhadaPCTconcentration2.0ng/ml.Conclusions:PCTisavaluablemarkerofsepsisandsepticshockinhematologicalpatientsandHSCTrecipientsevenwhenthebacteriologicaltestisnegativeandincaseswhenthepatientisafebrile.