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Infections Post Transplant

Procalcitonin, C-reactive protein, and endotoxin after bone marrow transplantation: identification of children at high risk of morbidity and mortality from sepsis

Bone Marrow Transplantation volume 31, pages 1137–1142 (2003)Cite this article

Summary:

We prospectively evaluated the capacity of serum procalcitonin (PCT), compared with serum levels of C-reactive protein (CRP) and endotoxin, to identify children at high risk for mortality from sepsis after BMT. Of 47 pediatric bone marrow transplantation patients studied, 22 had an uneventful course post-transplant (Group 1), 17 survived at least one septic event (Group 2), and eight died from multiorgan failure (MOF) following septic shock (Group 3). Median concentrations of PCT over the course of the study were 1.3, 15.2, and 102.8 ng/ml, respectively, in each of the three groups (P<0.002 for each comparison). Median concentrations of CRP were 91, 213, and 260 mg/l, respectively (P<0.001 for Group 1 vs Group 2 and Group 3; P=NS for Group 2 vs Group 3). Median concentrations of endotoxin were 0.21, 0.30, and 0.93 U/l, respectively (P=NS for each comparison). Median concentrations of PCT, in contrast to serum CRP and endotoxin, correlated with the severity of sepsis (8.2 ng/ml in ‘sepsis’ and 22.3 ng/ml in ‘severe sepsis’, P=0.028) and provided useful prognostic information during septic episodes.

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Acknowledgements

We thank Rüdiger Volland, Department of Biostatistics, Friedrich-Schiller University Jena, for his expert statistical advice. We thank Dr Marie Steiner, Department of Pediatrics, University of Minnesota, and Dr Ian Thornley, Massachusetts General and Children's Hospital, Boston, for a critical review of the manuscript. We are especially indebted to all the nurses of the Pediatric Bone Marrow Transplantation Unit, Friedrich-Schiller University Jena for their dedicated care of our young patients.

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Authors and Affiliations

  1. Department of Pediatrics, Division of Pediatric Hematology, Oncology and Bone Marrow Transplantation, University of Minnesota, MN, USA

    M Sauer

  2. Children's Hospital, Friedrich-Schiller-University, Jena, Germany

    K Tiede, D Fuchs, B Gruhn & F Zintl

  3. Department of Surgery, University of Ulm, Germany

    D Berger

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  1. M Sauer
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  2. K Tiede
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Sauer, M., Tiede, K., Fuchs, D. et al. Procalcitonin, C-reactive protein, and endotoxin after bone marrow transplantation: identification of children at high risk of morbidity and mortality from sepsis. Bone Marrow Transplant 31, 1137–1142 (2003). https://doi.org/10.1038/sj.bmt.1704045

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