Clinical utility of procalcitonin in bacterial infections in patients undergoing hematopoietic stem cell transplantation.

Background Infections are major contributor to morbidity and mortality in patients undergoing bone marrow transplant (BMT). Objective To assess role of serum procalcitonin (PCT) as a useful biomarker for the infections and outcomes in these patients. Methods Retrospective observational study. Results Total 47 patients with febrile episodes were enrolled. Twenty patients underwent autologous BMT and 27 underwent allogeneic BMT. Bacterial infections were documented in 18/47 (38%) patients. Forty patients were neutropenic. The median fever duration was 10 days (range 3-30 days) in positive procalcitonin level group whereas it was 4 days (range 1-18) in negative group. This was statistically significant (P=0.000). Procalcitonin levels were high in 8/9 episodes of sepsis (P=0.029). Intensive care unit transfers and death were significantly higher in PCT positive group as compared to PCT negative group. Conclusion Serum procalcitonin levels provide prognostic information of worse outcome in patients undergoing HSCT.