Prognostic value of procalcitonin and lipopolysaccharide binding protein in cancer patients with chemotherapy-associated febrile neutropenia presenting to an emergency department

被引:9
|
作者
Garcia de Guadiana-Romualdo, Luis [1 ]
Cerezuela-Fuentes, Pablo [2 ]
Espanol-Morales, Ignacio [3 ]
Esteban-Torrella, Patricia [1 ]
Jimenez-Santos, Enrique [1 ]
Hernando-Holgado, Ana [1 ]
Dolores Albaladejo-Oton, Maria [1 ]
机构
[1] Univ Hosp Santa Lucia, Biochem Dept, Cartagena, Spain
[2] Univ Hosp Santa Lucia, Clin Oncol Dept, Cartagena, Spain
[3] Univ Hosp Santa Lucia, Hematol Dept, Cartagena, Spain
关键词
febrile neutropenia; prognosis; Multinational Association for Supportive Care in Cancer; procalcitonin; lipopolysaccharide binding protein; C-REACTIVE PROTEIN; RISK-INDEX SCORE; MULTINATIONAL-ASSOCIATION; DIAGNOSTIC-ACCURACY; SUPPORTIVE-CARE; BACTEREMIA; SEPSIS; INTERLEUKIN-6; MANAGEMENT; INFECTION;
D O I
10.11613/BM.2019.010702
中图分类号
R446 [实验室诊断]; R-33 [实验医学、医学实验];
学科分类号
1001 ;
摘要
Introduction: Cancer patients with chemotherapy-induced febrile neutropenia are a heterogeneous group with a significant risk of serious medical complications. In these patients, the Multinational Association for Supportive Care in Cancer (MASCC) score is the most widely used tool for risk-stratification. The aim of this prospective study was to analyse the value of procalcitonin (PCT) and lipopolysaccharide binding protein (LBP) to predict serious complications and bacteraemia in cancer patients with febrile neutropenia, compared with MASCC score. Materials and methods: Data were collected from 111 episodes of febrile neutropenia admitted consecutively to the emergency department. In all of them, MASCC score was calculated and serum samples were collected for measurement of PCT and LBP by well-established methods. The main and secondary outcomes were the development of serious complications and bacteraemia, respectively. Results: A serious complication occurred in 20 (18%) episodes and in 16 (14%) bacteraemia was detected. Areas under the receiver operating characteristic curve (ROC AUC) of MASCC score, PCT and LBP to select low-risk patients were 0.83 (95% confidence interval (CI): 0.74 - 0.89), 0.85 (95% CI: 0.77 - 0.91) and 0.70 (95% CI: 0.61 - 0.78), respectively. For bacteraemia, MASCC score, PCT and LBP showed ROC AUCs of 0.74 (95% CI: 0.64 - 0.82), 0.86 (95% CI: 0.78 - 0.92) and 0.76 (95% CI: 0.67 - 0.83), respectively. Conclusion: A single measurement of PCT performs similarly as MASCC score to predict serious medical complications in cancer patients with febrile neutropenia and can be a useful tool for risk stratification. Besides, low PCT concentrations can be used to rule-out the presence of bacteraemia.
引用
收藏
页码:57 / 67
页数:11
相关论文
共 50 条
  • [1] PROGNOSTIC VALUE OF SERUM PROCALCITONIN LEVELS IN PATIENTS WITH FEBRILE NEUTROPENIA PRESENTING TO THE EMERGENCY DEPARTMENT
    Yadav, Sakshi
    Mathew, Roshan
    Sahu, Ankit Kumar
    Jamshed, Nayer
    Mohindra, Ritin
    Aggarwal, Praveen
    Batra, Atul
    Halder, Dipanjan
    Brunda, R. L.
    [J]. JOURNAL OF EMERGENCY MEDICINE, 2020, 60 (05): : 641 - 647
  • [2] Procalcitonin as an Early Predictor of Bacteremia in Cancer Patients With Febrile Neutropenia in the Emergency Department
    Choi, Sr S.
    Ahn, Sr S.
    Kim, Sr W.
    Kim, Sr W.
    Lim, Sr K.
    [J]. ANNALS OF EMERGENCY MEDICINE, 2011, 58 (04) : S221 - S221
  • [3] Serum procalcitonin measurement as diagnostic and prognostic marker in febrile adult patients presenting to the emergency department
    Hausfater, Pierre
    Juillien, Gaelle
    Madonna-Py, Beatrice
    Haroche, Julien
    Bernard, Maguy
    Riou, Bruno
    [J]. CRITICAL CARE, 2007, 11 (03)
  • [4] Serum procalcitonin measurement as diagnostic and prognostic marker in febrile adult patients presenting to the emergency department
    Pierre Hausfater
    Gaëlle Juillien
    Beatrice Madonna-Py
    Julien Haroche
    Maguy Bernard
    Bruno Riou
    [J]. Critical Care, 11
  • [5] Does serum procalcitonin have a diagnostic value in febrile adult patients presenting to the emergency department?
    van Oers, Jos A. H.
    Tulleken, Jaap E.
    Zijlstra, Jan G.
    [J]. CRITICAL CARE, 2007, 11 (06):
  • [6] Does serum procalcitonin have a diagnostic value in febrile adult patients presenting to the emergency department?
    Jos AH van Oers
    Jaap E Tulleken
    Jan G Zijlstra
    [J]. Critical Care, 11
  • [7] EFFECT OF HOSPITAL PROTOCOL ON THE TIMELY MANAGEMENT OF PATIENTS ON CHEMOTHERAPY PRESENTING TO THE EMERGENCY DEPARTMENT WITH FEBRILE NEUTROPENIA
    Chu, Grant
    Mediwake, Heshani
    Carr, Loretta
    Richmond, Joshua
    [J]. INTERNAL MEDICINE JOURNAL, 2013, 43 : 39 - 39
  • [8] Value of lipopolysaccharide binding protein as diagnostic marker of infection in adult cancer patients with febrile neutropenia: comparison with C-reactive protein, procalcitonin, and interleukin 6
    Garcia de Guadiana-Romualdo, Luis
    Espanol-Morales, Ignacio
    Cerezuela-Fuentes, Pablo
    Consuegra-Sanchez, Luciano
    Hernando-Holgado, Ana
    Esteban-Torrella, Patricia
    Jimenez-Santos, Enrique
    Viqueira-Gonzalez, Monserrat
    de Bejar-Almira, Africa
    Dolores Albaladejo-Oton, Maria
    [J]. SUPPORTIVE CARE IN CANCER, 2015, 23 (07) : 2175 - 2182
  • [9] Value of lipopolysaccharide binding protein as diagnostic marker of infection in adult cancer patients with febrile neutropenia: comparison with C-reactive protein, procalcitonin, and interleukin 6
    Luis García de Guadiana-Romualdo
    Ignacio Español-Morales
    Pablo Cerezuela-Fuentes
    Luciano Consuegra-Sánchez
    Ana Hernando-Holgado
    Patricia Esteban-Torrella
    Enrique Jiménez-Santos
    Monserrat Viqueira-González
    África de Béjar-Almira
    María Dolores Albaladejo-Otón
    [J]. Supportive Care in Cancer, 2015, 23 : 2175 - 2182
  • [10] Does serum procalcitonin have a diagnostic value in febrile adult patients presenting to the emergency department? Response
    van Oers, Jos A. H.
    Tulleken, Jaap E.
    Zijlstra, Jan G.
    [J]. CRITICAL CARE, 2007, 11 (06)