Significance of procalcitonin in bacterial infections among acute leukemia patients with post-chemotherapy agranulocytosis

Abstract

Introduction/Objective Bacterial infection caused by the lack of granulocytes that results from the chemotherapy of acute leukemia is the leading cause of death. At present, there are few sensitive markers to reflect the bacterial infection, and there is no obvious specificity for the diagnosis of infection. Procalcitonin (PCT) is a precursor of calcitonin, and it has been found that PCT is a rapid and accurate marker of infectious diseases in various studies, but its clinical value remained unclear. This study aimed to explore the clinical significance of PCT levels in patients with acute leukemia who have acquired bacterial infections during the agranulocytosis period post-chemotherapy.

Methods Serum PCT levels were analyzed from samples collected from 92 patients with acute leukemia who had acquired bacterial infections during the agranulocytosis period post-chemotherapy.

Results Serum PCT levels in patients with positive blood cultures were significantly higher than those in patients with negative blood cultures (р < 0.05). Gram-negative bacterial infection group was significantly more frequent cause of infection than the Gram-positive group (р < 0.05). Furthermore, for patients with positive blood cultures, serum PCT levels were significantly higher in patients who subsequently died than in those who survived (р < 0.05).

Conclusion In the period of agranulocytosis combined with bacterial infection that occurred after the chemotherapy of acute leukemia, PCT can show the status of bacterial infection, infected bacterial types and severities.

Keywords: procalcitonin; acute leukemia; bacterial Infections; agranulocytosis