title: Diagnostic value of serum procalcitonin and C-reactive protein for infections after allogeneic hematopoietic stem cell transplantation versus nontransplant setting.
abstract: OBJECTIVE
  Procalcitonin (PCT) has been increasingly used as a biomarker of infection. The purpose of this study was to evaluate its diagnostic value after hematopoietic stem cell transplantation (HSCT), where non-infectious febrile complications such as graft-versus-host disease frequently develop.
  
  
  METHODS
  We retrospectively analyzed 144 febrile episodes (infections: 82, and noninfections: 62) in adult patients with hematological disorders, including 57 and 87 episodes in HSCT and non-HSCT patients, respectively.
  
  
  RESULTS
  Of 57 febrile episodes in HSCT patients, 46 (86%) and 25 (44%) revealed positivity for C-reactive protein (CRP) and PCT, respectively. Among 87 febrile episodes in non-HSCT patients, 81 (93%) and 22 (25%) events showed positive results of CRP and PCT. Both of these biomarkers were associated with infectious episodes in univariate analysis. Multivariate analysis showed that a high cut-off level (>9.5 mg/dL) of CRP was a better indicator for infections than PCT in HSCT patients, while PCT positivity was more diagnostic for infections than any cutoff CRP level in non-HSCT patients.
  
  
  CONCLUSIONS
  It may be necessary to interpret the results of these biomarkers with different orders of priority in transplant versus nontransplant patients.
authors.affiliation: Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Mori
authors.forename: Kohta
authors.initials: K
authors.lastname: Miyawaki
authors.forename: Koji
authors.initials: K
authors.lastname: Kato
authors.forename: Katsuto
authors.initials: K
authors.lastname: Takenaka
authors.forename: Hiromi
authors.initials: H
authors.lastname: Iwasaki
authors.forename: Naoki
authors.initials: N
authors.lastname: Harada
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Miyamoto
authors.forename: Koichi
authors.initials: K
authors.lastname: Akashi
authors.forename: Takanori
authors.initials: T
authors.lastname: Teshima
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D005260:Female; D005334:Fever / Q000097:blood / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007239:Infections / Q000097:blood* / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011498:Protein Precursors / Q000097:blood*; D012189:Retrospective Studies; D014184:Transplantation, Homologous; D055815:Young Adult
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide