title: Diagnostic value of levels of presepsin (soluble CD14-subtype) in febrile neutropenia in patients with hematological disorders.
abstract: BACKGROUND
  Whether presepsin (soluble CD14-subtype) is better than other markers including procalcitonin (PCT), has not been adequately investigated in febrile neutropenia (FN).
  
  
  METHODS
  We prospectively examined the utility of presepsin in FN in Cohort 1 (C1) and 2 (C2), between November 2010 and February 2012, and between November 2013 and January 2014, respectively. The purpose of this study was to investigate 1) the relative value of serum presepsin over serum PCT in C1, and 2) the relative value of plasma presepsin as compared with serum PCT, C-reactive protein, interleukin-6 and interleukin-8 with frequent, repeated sampling in C2.
  
  
  RESULTS
  Seventy-nine FN episodes (C1, 75; C2, 4) were evaluable. In C1, when compared with control values, presepsin was significantly higher at onset of FN (P = 0.004), while PCT was not significantly higher (P = 0.54). The median value of serum presepsin within 72 h of onset of FN in subjects with fever of unknown origin, local infection, bacteremia and septic shock was 680 (reference 314) pg/ml, 763, 782 and 1359, respectively. In C2, the mean levels of plasma presepsin from onset of FN to 72 h were classified as negative in the two patients with no suspected site of infection, and those of the remaining two patients with clinically probable infections were positive (175, 131, 346 and 329 pg/ml, respectively). In contrast, the other markers did not discriminate between this two groups.
  
  
  CONCLUSIONS
  In FN, presepsin may be an earlier and more sensitive indicator of bacterial infection than PCT.
authors.affiliation: Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan. Electronic address: hide_koh@med.osaka-cu.ac.jp.
authors.forename: Hideo
authors.initials: H
authors.lastname: Koh
authors.affiliation: Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan.
authors.forename: Mizuki
authors.initials: M
authors.lastname: Aimoto
authors.affiliation: Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan.
authors.forename: Takako
authors.initials: T
authors.lastname: Katayama
authors.affiliation: Development Research, Mochida Pharmaceutical Co., Ltd, Shizuoka, Japan.
authors.forename: Masamichi
authors.initials: M
authors.lastname: Hashiba
authors.affiliation: Development Research, Mochida Pharmaceutical Co., Ltd, Shizuoka, Japan.
authors.forename: Ayumi
authors.initials: A
authors.lastname: Sato
authors.affiliation: Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan.
authors.forename: Masatomo
authors.initials: M
authors.lastname: Kuno
authors.affiliation: Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Makuuchi
authors.affiliation: Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan.
authors.forename: Teruto
authors.initials: T
authors.lastname: Takakuwa
authors.affiliation: Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Okamura
authors.affiliation: Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan.
authors.forename: Asao
authors.initials: A
authors.lastname: Hirose
authors.affiliation: Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan.
authors.forename: Mika
authors.initials: M
authors.lastname: Nakamae
authors.affiliation: Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Hino
authors.affiliation: Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan.
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Nakamae
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000097:blood*; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D002116:Calcitonin / Q000097:blood; D015331:Cohort Studies; D005260:Female; D006402:Hematologic Diseases / Q000097:blood* / Q000150:complications; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D018950:Lipopolysaccharide Receptors / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000097:blood* / Q000209:etiology; D010446:Peptide Fragments / Q000097:blood*; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D016209:Interleukin-8; D018950:Lipopolysaccharide Receptors; D010446:Peptide Fragments; C000594167:presepsin protein, human; D002116:Calcitonin; D002097:C-Reactive Protein
keywords: C-reactive protein; Febrile neutropenia; Interleukin-6; Interleukin-8; Presepsin (soluble CD14-subtype); Procalcitonin