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ctt-journal > Vavilov 1 et al. (Abstract)

Vavilov 1 et al. (Abstract)

Cellular Therapy and Transplantation (CTT), Vol. 3, No. 9
doi: 10.3205/ctt-2010-No9-abstract69
© The Authors. This abstract is provided under the following license: Creative Commons Attribution 3.0 Unported

Abstract accepted for "4th Raisa Gorbacheva Memorial Meeting on Hematopoietic Stem Cell Transplantation",
Saint Petersburg, Russia, September 18–20, 2010

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Evaluation of procalcitonin for diagnostics of septic complications in hematological patients and stem cell transplant recipients

Vladimir N. Vavilov, Mayya A. Toropova, Boris V. Afanasyev

R.M. Gorbacheva Memorial Institute of Children Hematology and Transplantation, Pavlov State Medical University, Saint-Petersburg, Russia

Correspondence: Vladimir N. Vavilov, R.M. Gorbacheva Memorial Institute of Children Hematology and Transplantation, Saint-Petersburg Pavlov State Medical University, 6/8, Tolstoy str., Saint-Petersburg, 197022, Russia, E-mail: vladimir_vavilov@spam is badmail.ru

Abstract

Background: Sepsis and septic shock are among the most dangerous complications in patients receiving conventional chemotherapy, hematopoietic stem cell transplantation (HSCT), and immunosuppressive treatment of graft-versus-host disease (GVHD). These diagnoses should usually have additional confirmation with specific biomarkers, such as procalcitonin (PCT).

Aim: To detect the significance and efficacy of PCT in the diagnosis of sepsis among hematological patients.

Patients and methods: Twenty-five patients receiving chemotherapy (n=13), HSCT (n=6), and GVHD treatment (n=6) with diagnosed sepsis were enrolled into the study. At the time of the infection 68% of them had neutropenia, and 88% fever. Diagnosis of sepsis was provided by microbiological assay, quantitative C-reactive protein (100% positive), and additionally verified by a semi-quantitative PCT-test (declared positive at levels greater than 2.0ng/ml). Microbiological detection was achieved in 72% of cases (n=18).

Results: The median of PCT was >2.0 ng/ml. PCT concentrations were >10.0 ng/ml in 52%, >2.0 ng/ml in 24%, >0.5 ng/ml in 8%, and <0.5 ng/ml in 16% of cases. Among the patients who were sepsis positive PCT was observed in 75%, with severe sepsis in 72.7%, and with septic shock in 80% of cases. In 28% of patients PCT was >2.0 ng/ml while the microbiology was negative. Three patients without fever and positive microbiology had a PCT concentration >2.0 ng/ml.

Conclusions: PCT is a valuable marker of sepsis and septic shock in hematological patients and HSCT recipients even when the bacteriological test is negative and in cases when the patient is afebrile.

Keywords: chemotherapy, HSCT, immunosuppressive therapy, sepsis, biomarker, procalcitonin

 

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