Assessment of systemic inflammation markers to differentiate a stable from a deteriorating clinical course in patients with febrile neutropenia

Eur J Haematol. 2005 Apr;74(4):297-303. doi: 10.1111/j.1600-0609.2004.00387.x.

Abstract

In this study, we evaluated the predictive values of procalcitonin (PCT), C-reactive protein (CRP), interleukin-6 (IL-6) and serum amyloid A (SAA) for determining the clinical course in febrile neutropenic patients. Daily plasma analyses during the fever course were performed in 101 episodes with fever and chemotherapy-induced neutropenia (neutrophil count <0.5 x 10(9)/L). Procalcitonin (PCT) and IL-6 values were significantly higher in febrile episodes in patients who developed complications. Procalcitonin with a cut-off value of < or =0.4 ng/mL or IL-6 < or =50 pg/mL 3 d after fever onset indicated daily high negative predictive values (NPVs) (91-100%) for episodes with complications. No marker could predict deterioration; however, daily low plasma concentrations of PCT or IL-6 during the first 8 d of fever were found to be a good predictor of no subsequent complications in neutropenic patients and therefore to be a helpful tool for limiting anti-microbial therapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / adverse effects
  • Biomarkers / blood
  • C-Reactive Protein / metabolism
  • Calcitonin / blood
  • Calcitonin Gene-Related Peptide
  • Female
  • Fever / blood*
  • Fever / etiology
  • Humans
  • Infections / blood
  • Infections / etiology
  • Interleukin-6 / blood
  • Male
  • Middle Aged
  • Neoplasms / complications
  • Neoplasms / drug therapy
  • Neutropenia / blood*
  • Neutropenia / etiology
  • Predictive Value of Tests
  • Prognosis
  • Protein Precursors / blood
  • Serum Amyloid A Protein / metabolism

Substances

  • Antineoplastic Agents
  • Biomarkers
  • CALCA protein, human
  • Interleukin-6
  • Protein Precursors
  • Serum Amyloid A Protein
  • Calcitonin
  • C-Reactive Protein
  • Calcitonin Gene-Related Peptide