title: The clinical value of biomarkers in respiratory complications in hematopoietic SCT.
abstract: To determine the role of biomarkers in the clinical management of respiratory complications (RC) in hematopoietic stem cell transplantation (HSCT) recipients, we have prospectively evaluated a cohort of 175 patients followed-up for 1 year after HSCT. To avoid misinterpretation, we have excluded both unidentified respiratory infections (RI) and mixed RI. A total of 64 RC were included. Plasma levels of C-reactive protein (CRP), procalcitonin (PCT) and proadrenomedullin (proADM) were measured at diagnosis and on day 3 and 7. Different cytokines were evaluated in serum on the first day. No HSCT recipients without RC were included as a control group. Compared with RI, non-infectious RC showed a significant increase in CRP, proADM and interleukin 6 on day 0 (P=0.005; P=0.03 and P=0.04, respectively). When only RI were considered, we observed that bacterial-fungal PI showed higher levels of CRP (P=0.02), PCT (P=0.04) and proADM (P<0.01). Persistent low levels of proADM biomarkers suggest viral infection (specificity and positive predictive value 100%). Patients dying of RC had PCT and proADM levels higher than survivors (P=0.002 and P=0.03, respectively). In HSCT recipients biomarkers increase in both infectious and non-infectious RC. They may have utility in the assessment of the severity of RC and in suspecting a viral etiology.
authors: Department of Pneumology, Hospital Clínic i Provincial, Barcelona, Spain.|Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.|University of Barcelona, Barcelona, Spain.
authors: C M
authors: CM
authors: Lucena
authors: Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.|HSCT Unit, Department of Hematology, Hospital Clínic I Provincial, Barcelona, Spain.
authors: M
authors: M
authors: Rovira
authors: Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
authors: A
authors: A
authors: Gabarrús
authors: Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.|Department of Biochemistry and Molecular Genetics, Hospital Clínic i Provincial, Barcelona, Spain.
authors: X
authors: X
authors: Filella
authors: Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.|HSCT Unit, Department of Hematology, Hospital Clínic I Provincial, Barcelona, Spain.
authors: C
authors: C
authors: Martínez
authors: Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
authors: R
authors: R
authors: Domingo
authors: Department of Pneumology, Hospital Clínic i Provincial, Barcelona, Spain.|Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.|University of Barcelona, Barcelona, Spain.|Centro de Investigación Biomédica En Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.
authors: A
authors: A
authors: Torres
authors: Department of Pneumology, Hospital Clínic i Provincial, Barcelona, Spain.|Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.|University of Barcelona, Barcelona, Spain.
authors: C
authors: C
authors: Agustí
mesh_terms: D000328:Adult; D064591:Allografts; D001424:Bacterial Infections / Q000097:blood / Q000209:etiology / Q000401:mortality; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D019337:Hematologic Neoplasms / Q000097:blood / Q000401:mortality / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000097:blood / Q000209:etiology / Q000401:mortality; D012141:Respiratory Tract Infections / Q000097:blood / Q000209:etiology / Q000401:mortality; D015996:Survival Rate
chemical_list: D015415:Biomarkers; C508600:IL6 protein, human; D015850:Interleukin-6; D002097:C-Reactive Protein