Utilización de procalcitonina y proteína C reactiva como marcadores de infección en la neutropenia febril de pacientes sometidos a trasplante de progenitores hematopoyéticos |
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Authors: | Marina Sánchez-Yepes Eduardo Aznar-Oroval Pablo Lorente-Alegre Tomás García-Lozano Isabel Picón-Roig Pilar Pérez-Ballestero Blanca Ortiz-Muñoz |
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Institution: | 1. Servicio de Laboratorio de Análisis Clínicos y Microbiología, Fundación Instituto Valenciano de Oncología, Valencia, España;2. Servicio de Hematología, Hospital de Manises, Manises, Valencia, España |
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Abstract: | Introduction and objectiveNeutropenia is a frequent sign in patients who are going to have a haematopoietic stem cell transplant (HSCT). Infection is an important complication in these patients, which is favoured by immunosuppression and the degree of neutropenia. This study aims to evaluate the diagnostic usefulness of procalcitonin (PCT) and C-reactive protein (CRP) in onco-haematological patients undergoing chemotherapy and HSCT to determine the origin of the fever.Patients and methodsPCT and CRP values were measured in 30 episodes of febrile neutropenia: before starting chemotherapy, appearance of neutropenia, onset of fever, days 1, 2, 3 and 6 after the onset of fever, and when the febrile episode ended. The episodes were classified as 5 bacteraemia, 3 microbiologically documented infections, 10 clinical infections, and 12 fevers of unknown origin.ResultsThe highest PCT mean values corresponded to the group of patients with bacteraemia. Statistically significant differences (P = .04) were found on the second day after the onset of fever. The cut-off point of 0.5 ng/ml showed a sensitivity of 66% and a specificity of 75%. PCR results showed statistically significant differences on days 1, 2 and 3 after the onset of fever (P = .01, P = .003, and P = .002, respectively). The cut-off point of 7.5 mg/L had a sensitivity of 88% and a specificity of 58%.ConclusionsThe combination of PCT and CRP is an insufficient method to detect bacterial infections and may not replace the proper clinical and microbiological diagnosis. |
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Keywords: | Procalcitonina Proteí na C reactiva Neutropenia febril |
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