The value of c-reactive protein and procalcitonin in febrile neutropenia

Abstract

Aim: Febrile neutropenia is the major cause of mortality and morbidity in cancer patients. For this reason, early diagnosis of severe infections and appropriate antimicrobial therapy are very important. The aim of this study was to investigate the difference between C-reactive protein (CRP) and procalcitonin in determining the sepsis and its severity.Materials and Method: A total of 30 children (35 episodes) with febrile neutropenia who were hospitalized in the Uludag University, Pediatric Hematology and Oncology Unit were included in this prospective study. The blood samples for CRP and procalcitonin were collected daily between 0 to 5th days. Serum CRP and procalcitonin levels were compared with culture positivity, prolonged fever, mucositis and absolute granulosit count (AGC).Results: A total of 16 patients (56%) diagnosed with acute leukemia and, 14 patients (46%) having solid tumours were evaluated. In sequential analysis of febrile episodes, both the median of procalcitonin and the CRP concentrations showed the same tendency and there was no significant correlation between them (r= 0.2, p> 0.05). There was no significant association between CRP and procalcitonin among those having positive culture and mucositis. However, CRP values at the 3rd, 4th and 5th days were significantly higher in the patients with AGC< 100/mm3 than those with AGC> 100/mm3. Similarly, CRP values were significantly higher at the 1st, 2nd, 3rd and 4th days among the patients having prolonged fever.Conclusion: Our study suggests that there is no difference between CRP and procalcitonin in determining sepsis and its severity. Although procalcitonin is a valuable acute phase reactant in non-neutropenic patients, larger prospective investigations are needed to show the prognostic value of procalcitonin in neutropenic patients.