Serum of interleukin-6 and procalcitonin as early diagnostic markers for the identification of poor hematopoietic reconstitution following allogeneic hematopoietic stem cell transplantation

Cancer. 2025 Apr 1;131(7):e35835. doi: 10.1002/cncr.35835.

Abstract

Background: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains a potential curative option for the treatment of various hematologic diseases. Poor hematopoietic reconstitution (PHR) is a common and serious complicating disease after allo-HSCT. The authors conducted a case-control study to determine the potential value of serum interleukin (IL)-6 and procalcitonin (PCT) levels during the peritransplantation period in predicting PHR after allo-HSCT.

Methods: The concentrations of IL-6 and PCT were compared, and a receiver operating characteristic (ROC) curve was constructed to determine the optimal cutoff values. Sensitivity and specificity were subsequently calculated.

Results: In our study, the levels of IL-6 and PCT were significantly elevated in patients with PHR compared to those in good hematopoietic restitution (GHR). The logistic regression analysis revealed that IL-6 and PCT posttransplantation were significant predictors of PHR after allo-HSCT. The calculation of the area under the curve (AUC) of IL-6 and PCT in predicting PHR was 0.805 and 0.724, respectively. The optimal cutoff values for PHR were 41.8 pg/mL and 0.404 ng/mL, with a sensitivity of 73.7% and 52.6% and a specificity of 81% and 85.7%, respectively. The AUC-ROC of IL-6 combined with PCT for predicting the PHR was 0.801, with a sensitivity of 75.4% and a specificity of 77.8%.

Conclusion: IL-6 and PCT can serve as potential biomarkers to predict PHR after allo-HSCT.

Keywords: allogeneic hematopoietic stem cell transplantation; diagnostic marker; hematopoietic reconstitution; interleukin‐6; procalcitonin.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Biomarkers / blood
  • Case-Control Studies
  • Female
  • Hematopoiesis*
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Humans
  • Interleukin-6* / blood
  • Male
  • Middle Aged
  • Procalcitonin* / blood
  • ROC Curve
  • Transplantation, Homologous
  • Young Adult

Substances

  • Interleukin-6
  • Procalcitonin
  • Biomarkers
  • IL6 protein, human