Procalcitonin and C-reactive protein do not discriminate between febrile reaction to anti-T-lymphocyte antibodies and Gram-negative sepsis

Bone Marrow Transplant. 2003 Nov;32(9):941-5. doi: 10.1038/sj.bmt.1704265.


Treatment with antibodies against T-lymphocytes usually triggers a febrile response potentially mimicking or masking infection. Procalcitonin (PCT) is considered a sensitive and specific marker of systemic bacterial and fungal infection. It was the aim of this study to investigate the characteristics of PCT and C-reactive protein (CRP) during treatment with polyclonal or monoclonal anti-T-cell antibodies, in order to examine the ability of these parameters to distinguish between systemic bacterial infection and reaction to antibody treatment. Thus, 15 consecutive febrile episodes after T-cell antibody infusion without clinical signs of infection were compared with nine episodes of Gram-negative sepsis. After T-cell antibody infusion PCT and CRP serum levels increased to a similar extent as in Gram-negative sepsis. Therefore, during T-cell antibody treatment neither PCT nor CRP are adequate for differentiating between fever due to infection or to unspecific cytokine release.

MeSH terms

  • Adolescent
  • Antibodies / adverse effects*
  • Antibodies / therapeutic use
  • Bacterial Infections / diagnosis
  • Biomarkers / blood
  • C-Reactive Protein / analysis*
  • Calcitonin / blood*
  • Calcitonin Gene-Related Peptide
  • Child
  • Child, Preschool
  • Diagnosis, Differential
  • Female
  • Fever / diagnosis
  • Fever / etiology*
  • Gram-Negative Bacteria
  • Humans
  • Infant
  • Male
  • Neoplasms / complications
  • Neoplasms / therapy
  • Protein Precursors / blood*
  • Sensitivity and Specificity
  • Sepsis / diagnosis*
  • T-Lymphocytes / immunology


  • Antibodies
  • Biomarkers
  • CALCA protein, human
  • Protein Precursors
  • Calcitonin
  • C-Reactive Protein
  • Calcitonin Gene-Related Peptide