Procalcitonin as a predictive marker of infections in chemoinduced neutropenia

Purpose: This study was designed to determine the usefulness of procalcitonin (PCT) as a predictive marker of infections in neutropenic patients following chemotherapeutic treatments. Methods: Over a 6-month period, 65 patients (34 affected by a solid tumor, 31 by a hematological disorder) were enrolled. Serum PCT concentrations were measured by an automated immunoassay on the leucocytes nadir and on the third day, when patients were checked for any sign of infection. Results: Procalcitonin values were not affected by gender, age, therapeutic approach, use of G-CSF or performance status and did not differ between patients who subsequently developed a localized infection and those who did not. PCT concentrations resulted higher in patients affected by hematological disorders than in those affected by solid tumors (mean value 0.09 vs. 0.05 μg/L; p < 0.0015) and in those who were hospitalized than in the outpatient group (0.10 vs. 0.05 μg/L; p < 0.0013). PCT levels correlated with the type of neoplastic disease (p = 0.016), the highest concentrations being detected in patients affected by acute leukemia. Conclusions: These findings suggest that PCT is not a useful predictive marker of infection in oncohematologic neutropenic patients, even though higher serum PCT concentrations are associated with hematological tumors as well as in-hospital admission. © 2009 Springer-Verlag.