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<p>Febrile neutropenia (FN) is a frequent and life–threatening complication in patients with haematological malignancies. The comparative value of procalcitonin (PCT) and C–reactive protein (CRP) for predicting bacteraemia and mortality in FN is not well established. We prospectively studied 280 FN episodes in 111 patients with haematological malignancies. PCT and CRP were measured at fever onset and at 48&#xa0;h. All patients received empirical antibiotics per protocol, independent of biomarker levels. Outcomes were bacteraemia (positive blood culture) and in–hospital mortality. Analysis was performed to assess the predictive ability of procalcitonin and CRP for these outcomes. Bacteraemia occurred in 66/280 (24%) episodes. At onset, the median [IQR (Q1-Q3)] PCT was 0.79 [0.29–6.06] ng/mL in bacteraemia versus 0.28 [0.14–0.81] ng/mL without (<i>p</i> &lt; 0.001). CRP was 97 [45–161] mg/L versus 65 [32–125] mg/L (<i>p</i> = 0.028). At 48&#xa0;h, PCT remained higher in bacteraemia (0.66 [0.27–6.20] vs. 0.36 [0.16–1.54] ng/mL, <i>p</i> = 0.001). In–hospital mortality occurred in 31/280 (11%). Median PCT at onset was 0.76 [0.29–2.12] ng/mL in non–survivors vs. 0.32 [0.15–1.26] ng/mL in survivors (<i>p</i> = 0.019). CRP did not significantly differ by mortality. PCT outperformed CRP for both outcomes. PCT is superior to CRP for predicting bacteraemia and mortality in FN among patients with haematological malignancies, and can aid early risk stratification while awaiting culture results.</p>

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Procalcitonin Is Superior To CRP in Predicting Bacteraemia and Mortality in Neutropenic Fever in Patients with Haematological Malignancies

  • 期刊论文

  • 发表日期：

    2026年1月12日

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  • Naveen Vairamoorthy,
  • Nitin Gupta,
  • Saikat Mondal,
  • Navneet Mishra,
  • Naman Bansal,
  • Shruti Sinha,
  • Priyamvadha Ramesh,
  • Meena Verma,
  • Jyoti Kotwal

摘要

Febrile neutropenia (FN) is a frequent and life–threatening complication in patients with haematological malignancies. The comparative value of procalcitonin (PCT) and C–reactive protein (CRP) for predicting bacteraemia and mortality in FN is not well established. We prospectively studied 280 FN episodes in 111 patients with haematological malignancies. PCT and CRP were measured at fever onset and at 48 h. All patients received empirical antibiotics per protocol, independent of biomarker levels. Outcomes were bacteraemia (positive blood culture) and in–hospital mortality. Analysis was performed to assess the predictive ability of procalcitonin and CRP for these outcomes. Bacteraemia occurred in 66/280 (24%) episodes. At onset, the median [IQR (Q1-Q3)] PCT was 0.79 [0.29–6.06] ng/mL in bacteraemia versus 0.28 [0.14–0.81] ng/mL without (p < 0.001). CRP was 97 [45–161] mg/L versus 65 [32–125] mg/L (p = 0.028). At 48 h, PCT remained higher in bacteraemia (0.66 [0.27–6.20] vs. 0.36 [0.16–1.54] ng/mL, p = 0.001). In–hospital mortality occurred in 31/280 (11%). Median PCT at onset was 0.76 [0.29–2.12] ng/mL in non–survivors vs. 0.32 [0.15–1.26] ng/mL in survivors (p = 0.019). CRP did not significantly differ by mortality. PCT outperformed CRP for both outcomes. PCT is superior to CRP for predicting bacteraemia and mortality in FN among patients with haematological malignancies, and can aid early risk stratification while awaiting culture results.