The relationship between level of procalcitonin and mortality in patients who have been followed for solid organ malignancy with febrile neutropenia

Abstract

Aims: Previous studies have demonstrated that certain laboratory indicators play a crucial role in the identification of infections and prognosis assessment in individuals afflicted with febrile neutropenia. The concentration of procalcitonin exhibits an elevation in the presence of bacterial and fungal infections, while remaining unaltered in the context of viral illnesses. The objective of this study was to assess the efficacy of procalcitonin as a diagnostic tool for detecting infection and predicting prognosis in patients with febrile neutropenia. Methods: The present investigation involved a retrospective analysis conducted at a single center, focusing on a cohort of 61 patients who received treatment for febrile neutropenia. The study encompassed the analysis of patients' age, gender, current circumstances, and laboratory test results. Procalcitonin levels were evaluated in first day of hospitalization. Results: The age range of the patients in the study varied from 18 to 84 years, with a median age of 58. Out of the whole sample, 29 individuals (47.5%) were female, while 32 individuals (52.5%) were male. Out of the total sample size, 27 patients (44.2%) were diagnosed with lung cancer, 13 patients (21.3%) were diagnosed with breast cancer, and 4 patients (14%) were diagnosed with testicular cancer. Out of the total patient population, 24 individuals exhibited microbiologically confirmed infections, while 9 patients presented with clinically characterized infections. Out of the total number of cases, 10 cases, accounting for 16.3% of the sample, led to fatality. The median procalcitonin values were 1.5 ng/ml in patients diagnosed with microbiologically confirmed infection and 0.6 ng/ml in those diagnosed with clinically suspected infection. Furthermore, it is worth noting that the median procalcitonin value among individuals with fever of unknown origin was found to be 0.6 ng/ml, with statistical significance indicated by a p-value of less than 0.001. The median procalcitonin level was found to be 17.70 ng/ml in instances resulting in mortality, whereas it was 0.56 ng/ml in cases without mortality (p<0.001). Conclusion: We determined that procalcitonin must be routinely used in order to show enfection and mortality in patients with febrile neutropenia. Because procalcitonin is a sufficient and appropriate examination to show infection and mortality so it can be beneficial to decide treatment method, and hospitalization. Procalcitonin may also be more useful in predicting the prognosis of patients with febrile neutropenia.