High pentraxin 3 level predicts septic shock and bacteremia at the onset of febrile neutropenia after intensive chemotherapy of hematologic patients

• Published in: Haematologica (Roma) Vol. 96; no. 9; pp. 1385 - 1389
• Main Authors: VÄNSKÄ, Matti, KOIVULA, Irma, HÄMÄLÄINEN, Sari, PULKKI, Kari, NOUSIAINEN, Tapio, JANTUNEN, Esa, JUUTILAINEN, Auni
• Format: Journal Article
• Language: English
• Published: Pavia Ferrata Storti Foundation 01.09.2011
• Subjects: Adolescent; Adult; Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; Bacteremia - diagnosis; Bacteremia - etiology; Biological and medical sciences; Biomarkers - metabolism; Brief Reports; C-Reactive Protein - metabolism; Emergency and intensive care: infection, septic shock; Female; Hematologic and hematopoietic diseases; Hematopoietic Stem Cell Transplantation; Humans; Intensive care medicine; Leukemia, Myeloid, Acute - therapy; Male; Medical sciences; Middle Aged; Neutropenia - chemically induced; Neutropenia - complications; Other diseases. Hematologic involvement in other diseases; Prognosis; Serum Amyloid P-Component - metabolism; Shock, Septic - diagnosis; Shock, Septic - etiology; Transplantation, Autologous; Young Adult; Human; C-reactive protein; Leukopenia; Hematology; Septic shock; Hemopathy; Pentraxine PTX3; febrile neutropenia; Bacteremia; Fever; Infection; Sepsis syndrome; Chemotherapy; Acute phase protein; Treatment; Age of onset; pentraxin 3; Bacteriosis; Predictive factor; C reactive protein; Neutropenia
• ISSN: 0390-6078; 1592-8721
• DOI: 10.3324/haematol.2011.044925

We evaluated pentraxin 3 as a marker for complications of neutropenic fever in 100 hematologic patients receiving intensive chemotherapy. Pentraxin 3 and C-reactive protein were measured at fever onset and then daily to day 3. Bacteremia was observed in 19 patients and septic shock in 5 patients (three deaths). In comparison to C-reactive protein, pentraxin 3 achieved its maximum more rapidly. Pentraxin 3 correlated not only with the same day C-reactive protein but also with the next day C-reactive protein. High pentraxin 3 on day 0 was associated with the development of septic shock (P=0.009) and bacteremia (P=0.046). The non-survivors had constantly high pentraxin 3 levels. To conclude, pentraxin 3 is an early predictor of complications in hematologic patients with neutropenic fever. High level of pentraxin 3 predicts septic shock and bacteremia already at the onset of febrile neutropenia. (ClinicalTrials.gov Identifier: NCT00781040.).