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

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. NishidaY. Kanda

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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.

Original languageEnglish
Pages (from-to)553-560
Number of pages8
JournalBone Marrow Transplantation
Volume49
Issue number4
DOIs
Publication statusPublished - 2014 Apr
Externally publishedYes

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Keywords

  • Allogeneic hematopoietic cell transplantation
  • Infectious events
  • Procalcitonin
  • Transplant-related complications

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Sato, M., Nakasone, H., Terasako-Saito, K., Sakamoto, K., Yamazaki, R., Tanaka, Y., Akahoshi, Y., Nakano, H., Ugai, T., Wada, H., Yamasaki, R., Ishihara, Y., Kawamura, K., Ashizawa, M., Kimura, S. I., Kikuchi, M., Tanihara, A., Kanda, J., Kako, S., ... Kanda, Y. (2014). Prediction of infectious complications by the combination of plasma procalcitonin level and localized infection before allogeneic hematopoietic cell transplantation. Bone Marrow Transplantation, 49(4), 553-560. https://doi.org/10.1038/bmt.2013.217