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
Affiliations
- Meng Shan
- Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Meng Shan
- National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China
- Meng Shan
- Institute of Blood and Marrow Transplantation, Soochow University, Suzhou, China
- Meng Shan
- Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
- Danya Shen
- Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Danya Shen
- National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China
- Danya Shen
- Institute of Blood and Marrow Transplantation, Soochow University, Suzhou, China
- Danya Shen
- Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
- Tiemei Song
- Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Tiemei Song
- National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China
- Tiemei Song
- Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
- Wenyan Xu
- Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Wenyan Xu
- National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China
- Wenyan Xu
- Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
- Huiying Qiu
- Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Huiying Qiu
- National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China
- Huiying Qiu
- Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
- Suning Chen
- Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Suning Chen
- National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China
- Suning Chen
- Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
- Yue Han
- Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Yue Han
- National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China
- Yue Han
- Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
- Xiaowen Tang
- Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Xiaowen Tang
- National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China
- Xiaowen Tang
- Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
- Miao Miao
- Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Miao Miao
- National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China
- Miao Miao
- Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
- Aining Sun
- Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Aining Sun
- National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China
- Aining Sun
- Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
- Depei Wu
- Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Depei Wu
- National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China
- Depei Wu
- Institute of Blood and Marrow Transplantation, Soochow University, Suzhou, China
- Depei Wu
- Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
- Yang Xu
- Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Yang Xu
- National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China
- Yang Xu
- Institute of Blood and Marrow Transplantation, Soochow University, Suzhou, China
- Yang Xu
- Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
- DOI
- https://doi.org/10.3389/fimmu.2022.843067
- Journal volume & issue
-
Vol. 13
Abstract
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
- procalcitonin
- allogeneic hematopoietic stem cell transplantation
- infectious disease
- prognosis
- nomogram
