Original scientific paper

https://doi.org/10.11613/BM.2019.010702

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

Luis García de Guadiana-Romualdo ; Biochemistry Department, University Hospital Santa Lucía, Cartagena, Spain
Pablo Cerezuela-Fuentes ; Clinical Oncology Department, University Hospital Santa Lucía, Cartagena, Spain
Ignacio Español-Morales ; Hematology Department, University Hospital Santa Lucía, Cartagena, Spain
Patricia Esteban-Torrella ; Biochemistry Department, University Hospital Santa Lucía, Cartagena, Spain
Enrique Jiménez-Santos ; Biochemistry Department, University Hospital Santa Lucía, Cartagena, Spain
Ana Hernando-Holgado ; Biochemistry Department, University Hospital Santa Lucía, Cartagena, Spain
María Dolores Albaladejo-Otón ; Biochemistry Department, University Hospital Santa Lucía, Cartagena, Spain

Abstract

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.

Keywords

febrile neutropenia; prognosis; Multinational Association for Supportive Care in Cancer; procalcitonin; lipopolysaccharide binding protein

Hrčak ID:

213856

URI

https://hrcak.srce.hr/213856

Publication date:

15.2.2019.

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