title: Evolution of procalcitonin, C-reactive protein and fibrinogen levels in neutropenic leukaemia patients with invasive pulmonary aspergillosis or mucormycosis.
abstract: Unlike bacterial infections, the value of procalcitonin (PCT) in detecting fungal infections in leukaemia patients is not clear. To determine whether the monitoring of PCT coupled with C-reactive protein (CRP) and fibrinogen (Fib) could be helpful in the management of pulmonary aspergillosis (IPA) or mucormycosis (PM), we retrospectively analysed the evolution of PCT, CRP and Fib levels in 94 leukaemia patients with proven/probable IPA (n = 77) or PM (n = 17) from D-12 to D12 relative to IFI onset defined as D0. Overall, 2140 assays were performed. From D-12 to D0, 12%, 5% and 1.4% of patients had PCT >0.5, 1 and 1.5 μg l(-1) , respectively, while CRP was >50, 75 and 100 mg l(-1) in 84%, 70% and 57% and Fib was >4, 5 and 6 g l(-1) in 96%, 80% and 61% of cases respectively (P < 10(-7) ). The same trends were observed from D1 to D12. Overall, between D-12 and D12, only 6.4% of patients had PCT >1.5 μg l(-1) , while CRP >100 mg l(-1) and Fib >6 g l(-1) were observed in 80% and 75% of cases respectively (P < 10(-7) ). In leukaemia patients, IPA or PM was accompanied by a significant increase in CRP and Fib while PCT remained low.
authors.affiliation: Department of Clinical Haematology, Dijon University Hospital, Dijon, France.
authors.forename: Marjorie
authors.initials: M
authors.lastname: Roques
authors.affiliation: Department of Clinical Haematology, Dijon University Hospital, Dijon, France.|Inserm Unit 866, LabEx team, Dijon School of Medicine, Dijon, France.
authors.forename: Marie Lorraine
authors.initials: ML
authors.lastname: Chretien
authors.affiliation: Department of Clinical Haematology, Dijon University Hospital, Dijon, France.
authors.forename: Camille
authors.initials: C
authors.lastname: Favennec
authors.affiliation: Department of Clinical Haematology, Dijon University Hospital, Dijon, France.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Lafon
authors.affiliation: Department of Clinical Haematology, Dijon University Hospital, Dijon, France.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Ferrant
authors.affiliation: Department of Clinical Haematology, Dijon University Hospital, Dijon, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Legouge
authors.affiliation: Department of Clinical Haematology, Dijon University Hospital, Dijon, France.
authors.forename: Alexia
authors.initials: A
authors.lastname: Plocque
authors.affiliation: Department of Clinical Haematology, Dijon University Hospital, Dijon, France.
authors.forename: Camille
authors.initials: C
authors.lastname: Golfier
authors.affiliation: Medical Biochemistry Laboratory, Dijon University Hospital, Dijon, France.
authors.forename: Laurence
authors.initials: L
authors.lastname: Duvillard
authors.affiliation: Department of Bacteriology, Dijon University Hospital, Dijon, France.
authors.forename: Lucie
authors.initials: L
authors.lastname: Amoureux
authors.affiliation: Department of Clinical Haematology, Dijon University Hospital, Dijon, France.|Inserm Unit 866, LabEx team, Dijon School of Medicine, Dijon, France.
authors.forename: Jean Noel
authors.initials: JN
authors.lastname: Bastie
authors.affiliation: Department of Biometrics, ICTA, Fontaine-les-Dijon, France.
authors.forename: Lory
authors.initials: L
authors.lastname: Maurin-Bernier
authors.affiliation: Department of Mycology and Parasitology, Dijon University Hospital, Dijon, France.
authors.forename: Frederic
authors.initials: F
authors.lastname: Dalle
authors.affiliation: Department of Clinical Haematology, Dijon University Hospital, Dijon, France.|Inserm Unit 866, LabEx team, Dijon School of Medicine, Dijon, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Caillot
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001230:Aspergillus / Q000302:isolation & purification; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D002116:Calcitonin / Q000097:blood*; D005260:Female; D005340:Fibrinogen / Q000032:analysis*; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000382:microbiology; D055744:Invasive Pulmonary Aspergillosis / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology; D007938:Leukemia / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009091:Mucormycosis / Q000097:blood / Q000175:diagnosis* / Q000382:microbiology; D009503:Neutropenia / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D015415:Biomarkers; D005340:Fibrinogen; D002116:Calcitonin; D002097:C-Reactive Protein
keywords: Procalcitonin; aspergillosis; leukaemia; mucormycosis; neutropenia