Fax: (713) 792-8233
Can procalcitonin distinguish infectious fever from tumor-related fever in non-neutropenic cancer patients?†
Article first published online: 17 MAY 2012
Copyright © 2012 American Cancer Society
Volume 118, Issue 23, pages 5823–5829, 1 December 2012
How to Cite
Shomali, W., Hachem, R., Chaftari, A.-M., Jiang, Y., Bahu, R., Jabbour, J., Raad, S., Al Shuaibi, M., Al Wohoush, I. and Raad, I. (2012), Can procalcitonin distinguish infectious fever from tumor-related fever in non-neutropenic cancer patients?. Cancer, 118: 5823–5829. doi: 10.1002/cncr.27602
We thank Brahms ThermoFisher for supplying the Kryptor system and procalcitonin kits. We are also grateful for Tanya Dvorak and Ruth Reitzel who assisted in performing the procalcitonin assays.
- Issue published online: 19 NOV 2012
- Article first published online: 17 MAY 2012
- Manuscript Accepted: 7 MAR 2012
- Manuscript Revised: 29 FEB 2012
- Manuscript Received: 24 JAN 2012
- infectious fever;
- tumor fever
Procalcitonin (PCT) has been proposed as a marker of infection and was studied in neutropenic patients. This study investigated its role in non-neutropenic febrile cancer patients (NNCPs).
Between July 2009 and July 2010, a total of 248 NNCPs with fever were studied. PCT was measured in plasma within 24 hours of fever onset and 4 to 7 days thereafter, using a Kryptor system with a lower limit of quantitation of 0.075 ng/mL. Patients' clinical, microbiological, and radiological data were reviewed to make the diagnosis and were correlated with PCT levels.
This study included 30 patients with bloodstream infection (BSI), 60 with localized bacterial infection, 141 with no documented infection, and 8 with tumor-related fever. Most patients (98%) were inpatients or admitted to the hospital during the study. Patients with BSI had significantly higher PCT levels than did those with documented localized infections (P = .048) and no documented infection (P = .011). PCT levels were significantly higher in septic patients than in those without sepsis (P = .012). Patients with stage IV disease or metastasis had significantly higher baseline PCT levels than did those with early stages of cancer (P < .05). PCT levels dropped significantly in patients with bacterial infections in response to antibiotics (P < .0001).
Baseline PCT levels are predictive of BSI and sepsis in NNCPs. They may be predictors of metastasis and advanced cancer. Subsequent decrease in PCT levels in response to antibiotics is suggestive of bacterial infection. Larger trials are needed to confirm the results of this pilot study. Cancer 2012. © 2012 American Cancer Society.