1327. Role of Procalcitonin in Cancer Patients with Infections
Session: Poster Abstract Session: Biomarkers and Correlates of Protection
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C

Background:

Procalcitonin (PCT) has emerged as a biomarker for different conditions over the last two decades. Previous studies showed that PCT levels correlate with presence of infections and has also been reported to be elevated in patients with neuroendocrine tumors and metastatic cancers.  

The purpose of the study was to evaluate the role of PCT as a biomarker of infections in a large cohort of cancer patients.

Materials and Methods:

We conducted a prospective, observational clinical laboratory study that included residual plasma samples from cancer patients who presented to M. D. Anderson Cancer Center between August 2009 and November 2009. Fresh plasma sample was collected from febrile cancer patients, non-febrile cancer patients, as well as non-cancer patients and control healthy volunteer subjects. Plasma PCT levels were measured by the Kryptor compact bioanalyzer, with a lower limit of detection 0.75 ng/ml and upper limit of 50ng/mL.

Results:

We identified 575 febrile cancer patients and 410 non-febrile cancer patients who had residual plasma samples, and 79 non-cancer individuals.

The median PCT level was higher in febrile cancer patients (0.310 ng/ml) compared to non-febrile cancer patients (0.099 ng/ml) as well as to the control group of non-cancer patients (0.029 ng/ml) (P<0.0001).

Among the febrile cancer patients, those who had sepsis or bacteremia (n=189) had a significant higher median PCT levels compared to those without microbiological documented infection (n=327) (median PCT= 0.490 ng/ml vs. 0.310 ng/ml; P=0.003).

The optimal cut-off point for PCT to differentiate cancer patients with bacteremia or sepsis vs. afebrile cancer patients without infection is 0.17 ng/ml. This cut-off point has a sensitivity of 81%, a specificity of 69%, a positive predictive value of 54% and a negative predictive value of 89%.

Conclusion:

In conclusion, our results suggest a potential role for PCT in the diagnosis of infections in cancer patients. Even though cancer patients tend to have higher PCT levels than individuals who don't have cancer, the levels are significantly higher when patients have documented infections compared to cancer patients without infections.

Anne Marie Chaftari, MD1, Munirah Alshuaibi, MD2, Mohamed Jamal, PhD3, Ruth Reitzel, MS4, Aline El Zakhem, MD5, Ying Jiang, MS4, Ray Hachem, MD6 and Issam Raad, MD4, (1)University of Texas, M.D. Anderson Cancer Center, Houston, TX, (2)UT MD Anderson Cancer Center, Houston, TX, (3)Infectious Diseases, Infection Control & Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX, (4)Infectious Diseases, Infection Control & Employee Health, University of Texas MD Anderson Cancer Center, Houston, TX, (5)Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX, (6)University of Texas M.D. Anderson Cancer Center, Houston, TX

Disclosures:

A. M. Chaftari, None

M. Alshuaibi, None

M. Jamal, None

R. Reitzel, None

A. El Zakhem, None

Y. Jiang, None

R. Hachem, None

I. Raad, American Medical Systems: , Licensing agreement or royalty
Cook: Speaker's Bureau, Grant recipient and Licensing agreement or royalty
ECP: ,
Great Lakes Pharmaceuticals: ,
Inventive Protocol, Inc.: ,
Medline: , Licensing agreement or royalty
TyRx: , Licensing agreement or royalty

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