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Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:

2024 09

Page:

1703-1708

Research Field:

Publishing date:

Info

Title:

The differential value of PCT and PSPN in infectious febrile neutropenia during chemotherapy for acute myeloid leukemia

Author(s):

QU Wei¹; SHANG Junfeng²; ZOU Huilin³; YANG Ruifang⁴

1.Department of Blood Transfusion，Yantai Affiliated Hospital of Binzhou Medical College,Shandong Yantai 264100，China;2.Department of Laboratory Medicine,Dongying District People's Hospital,Shandong Dongying 257000，China;3.Department of Hematology,Yantai Affiliated Hospital of Binzhou Medical College,Shandong Yantai 264100，China;4.Department of Medical Laboratory,Yantai Affiliated Hospital of Binzhou Medical College,Shandong Yantai 264100,China.

Keywords:

procalcitonin; presepsin; acute myeloid leukemia; febrile neutropenia

PACS:

R733

DOI:

10.3969/j.issn.1672-4992.2024.09.023

Abstract:

Objective:To investigate the identified value of procalcitonin(PCT) and presepsin(PSPN) in bacterial infection in patients with febrile neutropenia(FN) during chemotherapy for acute myeloid leukemia(AML).Methods:A total of 121 AML patients with FN who received chemotherapy in our hospital from July 2018 to February 2022 were included into the non-bacterial infection group FN and fever of unknown cause(negative bacterial culture,no clinical signs of infection) during chemotherapy and the bacterial infection group bacteremia(positive blood culture),local infection(negative blood culture,bacterial culture suggests local infection) and clinically confirmed infection.Plasma PCT and PSPN levels were detected by an enzyme-linked immunosorbent assay kit on the 1st to 3rd day of FN onset.Results:Compared with the non-bacterial infection group,the levels of PCT and PSPN in the bacterial infection group were significantly higher on the first to third day of FN onset,with statistical significance(P＜0.05).The area under the curve(AUC) for PCT level identification of FN bacterial infection at day 1,2 and 3 were 0.882,0.737 and 0.715,respectively,while the AUC for diagnosis of PSPN were 0.799,0.729 and 0.703,respectively.In addition,the combination of PCT and PSPN could further improve the AUC value of FN bacterial infection diagnosis(0.892,0.808,0.763).The risk of FN bacterial infection was significantly increased in patients with PCT≥2.02 ng/mL or PSPN≥2.40 μg/L on the first day of the disease(P＜0.05).After adjusting for confounding factors,the risk of FN bacterial infection in AML patients increased by 2.177~2.624 times when PSPN≥2.91 μg/L(P＜0.05).Spearman correlation analysis showed that PCT was positively correlated with sequential organ failure assessment(SOFA) score of bacterial sepsis patients(P＜0.001),but PSPN value was not significantly correlated with SOFA score(P＞0.05).Conclusion:Compared with PSPN,PCT was more accurate in distinguishing the causes of FN bacterial infection from non-infectious causes,and its concentration was related to the severity of bacterial sepsis.The combination of the two can further improve the diagnostic efficiency of PCT for FN bacterial infection.

References:

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山东省烟台市科技计划项目（编号：2022YD077)

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Last Update: 2024-03-29