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Infectious Complications

Prediction of infectious complications by the combination of plasma procalcitonin level and localized infection before allogeneic hematopoietic cell transplantation

Bone Marrow Transplantation volume 49, pages 553–560 (2014)Cite this article

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Abstract

We previously reported that the baseline C-reactive protein level did not predict infectious events after hematopoietic cell transplantation (HCT). Procalcitonin (PCT) has recently emerged as a powerful biomarker for the early diagnosis of bacterial infection. We evaluated the ability of the baseline PCT level to predict early infectious events after HCT in 79 recipients who received HCT between 2008 and 2012. The high-PCT group (⩾0.07 ng/mL, n=27) frequently experienced documented infection (DI) (21.2% vs 44.4% at day 30, P=0.038) and bloodstream infection (BSI) (15.4% vs 37.0% at day 30, P=0.035). In a multivariate analysis, however, the baseline PCT level was not significantly associated with DI (HR 2.01, P=0.089) or BSI (HR 2.28, P=0.084). Localized infection, such as anal canal problems, before the start of conditioning was seen in 26 patients. When we stratified the patients according to the presence of elevated PCT and localized infection, the group with elevated PCT and localized infection (n=17) was significantly associated with increased DI (HR 3.40, P=0.0074) and BSI (HR 3.59 P=0.0078) after HCT. A larger prospective observation is warranted to confirm the impact of the baseline PCT level and clinical features on the outcome of HCT.

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Authors and Affiliations

  1. Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan

    M Sato, H Nakasone, K Terasako-Saito, K Sakamoto, R Yamazaki, Y Tanaka, Y Akahoshi, H Nakano, T Ugai, H Wada, R Yamasaki, Y Ishihara, K Kawamura, M Ashizawa, S-i Kimura, M Kikuchi, A Tanihara, J Kanda, S Kako, J Nishida & Y Kanda

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  1. M Sato
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Correspondence to Y Kanda.

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Author contributions

MS designed the study, collected and analyzed the data, and wrote the manuscript. H Nakasone designed the study, analyzed the data and wrote the manuscript. KT-S, KS, R Yamazaki, YT, YA, H Nakano, TU, HW, R Yamasaki, YI, KK, MA, TM, S Kimura, MK, AT, JK, S Kako and JN collected the data. YK designed the study, analyzed the data, wrote the manuscript and was responsible for the study.

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Sato, M., Nakasone, H., Terasako-Saito, K. et al. Prediction of infectious complications by the combination of plasma procalcitonin level and localized infection before allogeneic hematopoietic cell transplantation. Bone Marrow Transplant 49, 553–560 (2014). https://doi.org/10.1038/bmt.2013.217

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