title: Pentraxin 3 predicts complicated course of febrile neutropenia in haematological patients, but the decision level depends on the underlying malignancy.
abstract: OBJECTIVE
  This study aimed at assessing the cut-off levels for pentraxin 3 (PTX3) in predicting complications of neutropenic fever (bacteraemia, septic shock) in haematological patients.
  
  
  METHODS
  A prospective study during 2006-2009 was performed at haematology ward in Kuopio University Hospital. A patient was eligible for the study if having neutropenic fever after intensive therapy for acute myeloid leukaemia (AML) (n = 32) or non-Hodgkin lymphoma (NHL) (n = 35). Blood cultures were taken, and maximal PTX3 and C-reactive protein (CRP) were evaluated during d0 to d3 from the beginning of fever onset.
  
  
  RESULTS
  The level of PTX3 was associated with both the underlying malignancy and the presence of complications, with highest level in NHL patients with complicated course of febrile neutropenia and lowest in AML patients with non-complicated course. The cut-off level of PTX3 to predict complications was ten-fold in patients with NHL (115 μg/L) in comparison with patients with AML (11.5 μg/L). In combined analysis based on separate cut-offs, PTX3 predicted complications of febrile neutropenia with sensitivity of 0.86, specificity of 0.83, positive predictive value of 0.57 and negative predictive value of 0.96.
  
  
  CONCLUSIONS
  PTX3 was superior to CRP in predicting complicated course of febrile neutropenia, but only when the effect of the underlying malignancy had been taken into account.
authors.affiliation: Institute of Clinical Medicine/Internal Medicine, University of Eastern Finland, Kuopio Department of Medicine, Kuopio University Hospital, Kuopio, Finland. auni.juutilainen@kuh.fi
authors.forename: Auni
authors.initials: A
authors.lastname: Juutilainen
authors.forename: Matti
authors.initials: M
authors.lastname: Vänskä
authors.forename: Kari
authors.initials: K
authors.lastname: Pulkki
authors.forename: Sari
authors.initials: S
authors.lastname: Hämäläinen
authors.forename: Tapio
authors.initials: T
authors.lastname: Nousiainen
authors.forename: Esa
authors.initials: E
authors.lastname: Jantunen
authors.forename: Irma
authors.initials: I
authors.lastname: Koivula
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000502:physiology*; D005260:Female; D005334:Fever / Q000150:complications / Q000382:microbiology / Q000473:pathology*; D019337:Hematologic Neoplasms / Q000145:classification / Q000150:complications / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000150:complications / Q000473:pathology*; D011446:Prospective Studies; D000683:Serum Amyloid P-Component / Q000502:physiology*; D055815:Young Adult; D000099153:Pentraxins
chemical_list: D002097:C-Reactive Protein; D000683:Serum Amyloid P-Component; D000099153:Pentraxins