THE CLINICAL SIGNIFICANCE OF PROCALCITONIN MONITORING IN INFECTED PATIENTS WITH HEMATOPATHY
(Abstract release date: 05/19/16)
EHA Library. Sun A. 06/09/16; 134789; PB1889
Mr. Aining Sun
Contributions
Contributions
Abstract
Abstract: PB1889
Type: Publication Only
Background
Due to the application of the drugs such as high doses of chemotherapy, immune inhibitors and hormone, hematopathy patients are becoming more likely to get granulocyte lack and the resistence to infection..For those patients with the application of the peripheral venipuncture in granulocyte lack period, infection incidence can be as high as 53% ~ 80%.Accordingly,infection is one of the most common life-threatening complications, and therefore the early diagnosis and treatment of infection is very important to better prognosis. But now there is no sufficient sensitive markers to reflect the level of inflection in hematopathy patients.Traditional markers such as the number of white blood cells, C - reactive protein have no obvious specificity in the diagnosis of hematologic malignancies with infection.Positive bacteriology of blood culture is the only gold standard in the diagnosis of patients with bloodstream infections.However, it can't meet the requirements for early and rapid diagnosis,because the blood culture positive rate is only 10% ~ 20%, and pathogen isolation and culture time is long;Calcitonin original protein (PCT) is the precursor of calcitonin,which has been proven to be high in a variety of disease infection since it was found in 1993.Furthermore,it is a sensitive and specific indicator in early granulocyte lack with severe bacterial infections.
Aims
To evaluate the clinical value of procalcitonin(PCT) measurement and its dynamic monitoring in hematopathy patients undergoing chemotherapy or transplant- related infections.
Methods
The clinical data were collected and analyzed retrospectivey in 497 hematopathy patients with serum PCT above 0.5μg/L.The procalcitonin were compared between the patients with septic shock and those without.The procalcitonin were also compared between the patients with positive blood culture and those with negative blood culture.Further,theprocalcitonin were compared between the patients with gram—positive bloodstream infection and those with gram—negative bloodstream infection.Receiver operating characteristic( ROC) curve was used to evaluate the diagnostic value of procalcitonin in predicting sepsis.PCT values were collected at the onset of fever and 3、7、14、21、28days after antimicrobial therapy.The dynamic change of PCT after operation was compared between the patients whose infection was successfully controlled and those without adequate control.
Results
There were totally 497 hematopathy patients with serum PCT value > 0.5μg/L, 421（84.7%,421/497）cases among whom were diagnosed with infection based on clinical symptoms and microbiological assays.Out of these 421 patients, we found that 296（70.3%，296/421） cases’PCT values increased (>0.50μg/L)within 24 hours after having a fever.The median(range)procalcitonin level[ 6.29（0.505-100）μg/L]was significantly higher in 59（14.0%，59/421）patients with septic shock than in those（86.0%，362/421）without [1.16（0.502-100μg/L,Z=-7.726,P<0.01].408 patients received blood culture examination.The median(range)procalcitoninlevel[2.47（0.508-100）μg/L]was significantly higher than in 167 patients with positive blood culture than in 240 patients with negative blood culture[1.15（0.501-100）μg/L，Z=-5.762，P<0.01].Additionally, the median(range)procalcitoninlevel[ 4.315（0.508-100）μg/L] was significantly higher in 108(64.7%，108/167）patients with gram-negative sepsis than in 37（22.2%，37/167）patients with Gram- positive sepsis[1.39(0.521-55.44）μg/L，Z=-2.024，P<0.01].The area under the curve(AUC)for PCT was 0.670，whereas a cut-off value of 2.05μg/L,provided the best sensitivity and specificity with a value of 54.3％ and 70%,respectively. The dynamic changes of 289 monitoring PCT patients reflected the infection course．No significant difference was found between the patients with deteriorate and persistent infection and those whose infection was successfully eradicated properly within 72 hours(P>0.05)．However,the PCT after 72 hours were significantly different among the three group( All P<0.01).
Conclusion
Procalcitonin monitoring could be used as a rapid and supplementary diagnostic marker of infection,especially in blood culture-negative infected patients.Additionally,its dynamic change could also reflect the infection course,which provides a better guide for the use of antibiotics.
Session topic: E-poster
Keyword(s): Diagnosis, Infection
Type: Publication Only
Background
Due to the application of the drugs such as high doses of chemotherapy, immune inhibitors and hormone, hematopathy patients are becoming more likely to get granulocyte lack and the resistence to infection..For those patients with the application of the peripheral venipuncture in granulocyte lack period, infection incidence can be as high as 53% ~ 80%.Accordingly,infection is one of the most common life-threatening complications, and therefore the early diagnosis and treatment of infection is very important to better prognosis. But now there is no sufficient sensitive markers to reflect the level of inflection in hematopathy patients.Traditional markers such as the number of white blood cells, C - reactive protein have no obvious specificity in the diagnosis of hematologic malignancies with infection.Positive bacteriology of blood culture is the only gold standard in the diagnosis of patients with bloodstream infections.However, it can't meet the requirements for early and rapid diagnosis,because the blood culture positive rate is only 10% ~ 20%, and pathogen isolation and culture time is long;Calcitonin original protein (PCT) is the precursor of calcitonin,which has been proven to be high in a variety of disease infection since it was found in 1993.Furthermore,it is a sensitive and specific indicator in early granulocyte lack with severe bacterial infections.
Aims
To evaluate the clinical value of procalcitonin(PCT) measurement and its dynamic monitoring in hematopathy patients undergoing chemotherapy or transplant- related infections.
Methods
The clinical data were collected and analyzed retrospectivey in 497 hematopathy patients with serum PCT above 0.5μg/L.The procalcitonin were compared between the patients with septic shock and those without.The procalcitonin were also compared between the patients with positive blood culture and those with negative blood culture.Further,theprocalcitonin were compared between the patients with gram—positive bloodstream infection and those with gram—negative bloodstream infection.Receiver operating characteristic( ROC) curve was used to evaluate the diagnostic value of procalcitonin in predicting sepsis.PCT values were collected at the onset of fever and 3、7、14、21、28days after antimicrobial therapy.The dynamic change of PCT after operation was compared between the patients whose infection was successfully controlled and those without adequate control.
Results
There were totally 497 hematopathy patients with serum PCT value > 0.5μg/L, 421（84.7%,421/497）cases among whom were diagnosed with infection based on clinical symptoms and microbiological assays.Out of these 421 patients, we found that 296（70.3%，296/421） cases’PCT values increased (>0.50μg/L)within 24 hours after having a fever.The median(range)procalcitonin level[ 6.29（0.505-100）μg/L]was significantly higher in 59（14.0%，59/421）patients with septic shock than in those（86.0%，362/421）without [1.16（0.502-100μg/L,Z=-7.726,P<0.01].408 patients received blood culture examination.The median(range)procalcitoninlevel[2.47（0.508-100）μg/L]was significantly higher than in 167 patients with positive blood culture than in 240 patients with negative blood culture[1.15（0.501-100）μg/L，Z=-5.762，P<0.01].Additionally, the median(range)procalcitoninlevel[ 4.315（0.508-100）μg/L] was significantly higher in 108(64.7%，108/167）patients with gram-negative sepsis than in 37（22.2%，37/167）patients with Gram- positive sepsis[1.39(0.521-55.44）μg/L，Z=-2.024，P<0.01].The area under the curve(AUC)for PCT was 0.670，whereas a cut-off value of 2.05μg/L,provided the best sensitivity and specificity with a value of 54.3％ and 70%,respectively. The dynamic changes of 289 monitoring PCT patients reflected the infection course．No significant difference was found between the patients with deteriorate and persistent infection and those whose infection was successfully eradicated properly within 72 hours(P>0.05)．However,the PCT after 72 hours were significantly different among the three group( All P<0.01).
Conclusion
Procalcitonin monitoring could be used as a rapid and supplementary diagnostic marker of infection,especially in blood culture-negative infected patients.Additionally,its dynamic change could also reflect the infection course,which provides a better guide for the use of antibiotics.
Session topic: E-poster
Keyword(s): Diagnosis, Infection
Abstract: PB1889
Type: Publication Only
Background
Due to the application of the drugs such as high doses of chemotherapy, immune inhibitors and hormone, hematopathy patients are becoming more likely to get granulocyte lack and the resistence to infection..For those patients with the application of the peripheral venipuncture in granulocyte lack period, infection incidence can be as high as 53% ~ 80%.Accordingly,infection is one of the most common life-threatening complications, and therefore the early diagnosis and treatment of infection is very important to better prognosis. But now there is no sufficient sensitive markers to reflect the level of inflection in hematopathy patients.Traditional markers such as the number of white blood cells, C - reactive protein have no obvious specificity in the diagnosis of hematologic malignancies with infection.Positive bacteriology of blood culture is the only gold standard in the diagnosis of patients with bloodstream infections.However, it can't meet the requirements for early and rapid diagnosis,because the blood culture positive rate is only 10% ~ 20%, and pathogen isolation and culture time is long;Calcitonin original protein (PCT) is the precursor of calcitonin,which has been proven to be high in a variety of disease infection since it was found in 1993.Furthermore,it is a sensitive and specific indicator in early granulocyte lack with severe bacterial infections.
Aims
To evaluate the clinical value of procalcitonin(PCT) measurement and its dynamic monitoring in hematopathy patients undergoing chemotherapy or transplant- related infections.
Methods
The clinical data were collected and analyzed retrospectivey in 497 hematopathy patients with serum PCT above 0.5μg/L.The procalcitonin were compared between the patients with septic shock and those without.The procalcitonin were also compared between the patients with positive blood culture and those with negative blood culture.Further,theprocalcitonin were compared between the patients with gram—positive bloodstream infection and those with gram—negative bloodstream infection.Receiver operating characteristic( ROC) curve was used to evaluate the diagnostic value of procalcitonin in predicting sepsis.PCT values were collected at the onset of fever and 3、7、14、21、28days after antimicrobial therapy.The dynamic change of PCT after operation was compared between the patients whose infection was successfully controlled and those without adequate control.
Results
There were totally 497 hematopathy patients with serum PCT value > 0.5μg/L, 421（84.7%,421/497）cases among whom were diagnosed with infection based on clinical symptoms and microbiological assays.Out of these 421 patients, we found that 296（70.3%，296/421） cases’PCT values increased (>0.50μg/L)within 24 hours after having a fever.The median(range)procalcitonin level[ 6.29（0.505-100）μg/L]was significantly higher in 59（14.0%，59/421）patients with septic shock than in those（86.0%，362/421）without [1.16（0.502-100μg/L,Z=-7.726,P<0.01].408 patients received blood culture examination.The median(range)procalcitoninlevel[2.47（0.508-100）μg/L]was significantly higher than in 167 patients with positive blood culture than in 240 patients with negative blood culture[1.15（0.501-100）μg/L，Z=-5.762，P<0.01].Additionally, the median(range)procalcitoninlevel[ 4.315（0.508-100）μg/L] was significantly higher in 108(64.7%，108/167）patients with gram-negative sepsis than in 37（22.2%，37/167）patients with Gram- positive sepsis[1.39(0.521-55.44）μg/L，Z=-2.024，P<0.01].The area under the curve(AUC)for PCT was 0.670，whereas a cut-off value of 2.05μg/L,provided the best sensitivity and specificity with a value of 54.3％ and 70%,respectively. The dynamic changes of 289 monitoring PCT patients reflected the infection course．No significant difference was found between the patients with deteriorate and persistent infection and those whose infection was successfully eradicated properly within 72 hours(P>0.05)．However,the PCT after 72 hours were significantly different among the three group( All P<0.01).
Conclusion
Procalcitonin monitoring could be used as a rapid and supplementary diagnostic marker of infection,especially in blood culture-negative infected patients.Additionally,its dynamic change could also reflect the infection course,which provides a better guide for the use of antibiotics.
Session topic: E-poster
Keyword(s): Diagnosis, Infection
Type: Publication Only
Background
Due to the application of the drugs such as high doses of chemotherapy, immune inhibitors and hormone, hematopathy patients are becoming more likely to get granulocyte lack and the resistence to infection..For those patients with the application of the peripheral venipuncture in granulocyte lack period, infection incidence can be as high as 53% ~ 80%.Accordingly,infection is one of the most common life-threatening complications, and therefore the early diagnosis and treatment of infection is very important to better prognosis. But now there is no sufficient sensitive markers to reflect the level of inflection in hematopathy patients.Traditional markers such as the number of white blood cells, C - reactive protein have no obvious specificity in the diagnosis of hematologic malignancies with infection.Positive bacteriology of blood culture is the only gold standard in the diagnosis of patients with bloodstream infections.However, it can't meet the requirements for early and rapid diagnosis,because the blood culture positive rate is only 10% ~ 20%, and pathogen isolation and culture time is long;Calcitonin original protein (PCT) is the precursor of calcitonin,which has been proven to be high in a variety of disease infection since it was found in 1993.Furthermore,it is a sensitive and specific indicator in early granulocyte lack with severe bacterial infections.
Aims
To evaluate the clinical value of procalcitonin(PCT) measurement and its dynamic monitoring in hematopathy patients undergoing chemotherapy or transplant- related infections.
Methods
The clinical data were collected and analyzed retrospectivey in 497 hematopathy patients with serum PCT above 0.5μg/L.The procalcitonin were compared between the patients with septic shock and those without.The procalcitonin were also compared between the patients with positive blood culture and those with negative blood culture.Further,theprocalcitonin were compared between the patients with gram—positive bloodstream infection and those with gram—negative bloodstream infection.Receiver operating characteristic( ROC) curve was used to evaluate the diagnostic value of procalcitonin in predicting sepsis.PCT values were collected at the onset of fever and 3、7、14、21、28days after antimicrobial therapy.The dynamic change of PCT after operation was compared between the patients whose infection was successfully controlled and those without adequate control.
Results
There were totally 497 hematopathy patients with serum PCT value > 0.5μg/L, 421（84.7%,421/497）cases among whom were diagnosed with infection based on clinical symptoms and microbiological assays.Out of these 421 patients, we found that 296（70.3%，296/421） cases’PCT values increased (>0.50μg/L)within 24 hours after having a fever.The median(range)procalcitonin level[ 6.29（0.505-100）μg/L]was significantly higher in 59（14.0%，59/421）patients with septic shock than in those（86.0%，362/421）without [1.16（0.502-100μg/L,Z=-7.726,P<0.01].408 patients received blood culture examination.The median(range)procalcitoninlevel[2.47（0.508-100）μg/L]was significantly higher than in 167 patients with positive blood culture than in 240 patients with negative blood culture[1.15（0.501-100）μg/L，Z=-5.762，P<0.01].Additionally, the median(range)procalcitoninlevel[ 4.315（0.508-100）μg/L] was significantly higher in 108(64.7%，108/167）patients with gram-negative sepsis than in 37（22.2%，37/167）patients with Gram- positive sepsis[1.39(0.521-55.44）μg/L，Z=-2.024，P<0.01].The area under the curve(AUC)for PCT was 0.670，whereas a cut-off value of 2.05μg/L,provided the best sensitivity and specificity with a value of 54.3％ and 70%,respectively. The dynamic changes of 289 monitoring PCT patients reflected the infection course．No significant difference was found between the patients with deteriorate and persistent infection and those whose infection was successfully eradicated properly within 72 hours(P>0.05)．However,the PCT after 72 hours were significantly different among the three group( All P<0.01).
Conclusion
Procalcitonin monitoring could be used as a rapid and supplementary diagnostic marker of infection,especially in blood culture-negative infected patients.Additionally,its dynamic change could also reflect the infection course,which provides a better guide for the use of antibiotics.
Session topic: E-poster
Keyword(s): Diagnosis, Infection
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