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, Pablo Cerezuela-Fuentes, Ignacio Español-Morales, Patricia Esteban-Torrella, Enrique Jiménez-Santos, Ana Hernando-Holgado, María Dolores Albaladejo-Otón.
Sažetak

Introduction: Cancer patients with chemotherapy-induced febrile neutropenia are a heterogeneous group with a significant risk of serious medicalcomplications. 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 predictserious 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. Inall of them, MASCC score was calculated and serum samples were collected for measurement of PCT and LBP by well-established methods. The mainand 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 characteristiccurve (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 febrileneutropenia and can be a useful tool for risk stratification. Besides, low PCT concentrations can be used to rule-out the presence of bacteraemia.