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Microbial Issues

The clinical role of procalcitonin in hematopoietic SCT

Bone Marrow Transplantation volume 47, pages 1326–1331 (2012)Cite this article

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Abstract

Infectious disease following hematopoietic SCT (HSCT) is a major cause of TRM. The more valuable markers to distinguish infections disease from non-infectious complications are needed. Procalcitonin (PCT) and C-reactive protein (CRP) were measured periodically throughout the clinical course of consecutive 28 patients who underwent HSCT. The diagnoses of 103 febrile episodes were analyzed. PCT and CRP level on the first day of fever significantly increased in systemic bacterial or fungal infection (P<0.001 and <0.001, respectively). PCT is more valuable than CRP for discrimination between systemic bacterial or fungal infection and intracellular infection (P=0.022 and 0.447, respectively). The area under receiver-operator characteristics curve for detection of bacterial or fungal infection was 0.82 for PCT and 0.76 for CRP. When PCT levels did not increase over 0.25 ng/mL through the fifth day of fever, PCT yielded a specificity of 100.0%. In multivariate analysis, the maximum level of PCT during a whole course of HSCT>=2 ng/mL was independently associated with worse overall survival as post-transplant predictors (adjusted hazard ratio 6.42, P=0.035). PCT provide additional information for discrimination between bacterial or fungal infection and other causes and predicting the patient’s prognosis after HSCT.

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Acknowledgements

We appreciate Wako Pure Chemical Industries, Japan, for measuring procalcitonin concentrations.

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Authors and Affiliations

  1. Department of Hematology and Oncology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan

    J Koya, Y Nannya, M Ichikawa & M Kurokawa

  2. Department of Cell Therapy and Transplantation, University of Tokyo Hospital, Tokyo, Japan

    M Kurokawa

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  1. J Koya
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  3. M Ichikawa
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Correspondence to M Kurokawa.

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Koya, J., Nannya, Y., Ichikawa, M. et al. The clinical role of procalcitonin in hematopoietic SCT. Bone Marrow Transplant 47, 1326–1331 (2012). https://doi.org/10.1038/bmt.2012.18

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