Frontiers in Immunology (Apr 2022)

The Clinical Value of Procalcitonin in the Neutropenic Period After Allogeneic Hematopoietic Stem Cell Transplantation

  • Meng Shan,
  • Meng Shan,
  • Meng Shan,
  • Meng Shan,
  • Danya Shen,
  • Danya Shen,
  • Danya Shen,
  • Danya Shen,
  • Tiemei Song,
  • Tiemei Song,
  • Tiemei Song,
  • Wenyan Xu,
  • Wenyan Xu,
  • Wenyan Xu,
  • Huiying Qiu,
  • Huiying Qiu,
  • Huiying Qiu,
  • Suning Chen,
  • Suning Chen,
  • Suning Chen,
  • Yue Han,
  • Yue Han,
  • Yue Han,
  • Xiaowen Tang,
  • Xiaowen Tang,
  • Xiaowen Tang,
  • Miao Miao,
  • Miao Miao,
  • Miao Miao,
  • Aining Sun,
  • Aining Sun,
  • Aining Sun,
  • Depei Wu,
  • Depei Wu,
  • Depei Wu,
  • Depei Wu,
  • Yang Xu,
  • Yang Xu,
  • Yang Xu,
  • Yang Xu

DOI
https://doi.org/10.3389/fimmu.2022.843067
Journal volume & issue
Vol. 13

Abstract

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The diagnostic value of procalcitonin and the prognostic role of PCT clearance remain unclear in neutropenic period after allogeneic hematopoietic stem cell transplantation introduction. This study evaluated 219 febrile neutropenic patients (116, retrospectively; 103, prospectively) who underwent allo-HSCT from April 2014 to March 2016. The area under the receiver operator characteristic curve (AUC) of PCT for detecting documented infection (DI) was 0.637, and that of bloodstream infection (BSI) was 0.811. In multivariate analysis, the inability to decrease PCT by more than 80% within 5–7 days after the onset of fever independently predicted poor 100-day survival following allo-HSCT (P = 0.036). Furthermore, the prognostic nomogram combining PCTc and clinical parameters showed a stable predictive performance, supported by the C-index of 0.808 and AUC of 0.813 in the primary cohort, and C-index of 0.691 and AUC of 0.697 in the validation cohort. This study demonstrated the diagnostic role of PCT in documented and bloodstream infection during the neutropenic period after allo-HSCT. PCTc might serve as a predictive indicator of post-HSCT 100-day mortality. A nomogram based on PCTc and several clinical factors effectively predicted the 100-day survival of febrile patients and may help physicians identify high-risk patients in the post-HSCT neutropenic period.

Keywords