PCT is a 116 amino acid protein with an identical sequence to that of the prohormone of calcitonin. Bacterial endotoxins or systemic fungal infections are the most important stimulus for PCT raising. On the contrary, viral, neoplastic and autoimmune diseases do not induce PCT elevation. In vivo PCT half-life of 20-24 hours and its high stability in plasma and serum qualify PCT as an optimal marker for the daily monitoring of infections. We enrolled 33 pediatric pts, median age 7 years (range 1-16), who underwent allogeneic or autologous stem cell transplantation for oncohematological diseases. PCT was measured before the conditioning therapy for the transplant (steady state), at wbc nadir and subsequently on alternate days. The presence of fever, neutropenia, antibiotic/antifungal therapy, acute GvHD, CMV status and microbial cultures were recorded. A median of 8 (range 4-13 ) PCT determinations per pt was performed. PCT was found above the normal values (37,5 ,C (47,8 %). In 15/23 pts (65,2 %) with high PCT values it was not possible to detect any microbial positivity. Moreover, it was not observed any kind of correlation between elevated PCT values and cytopenia while a strict relationship between normalization of PCT values and the introduction of Teicoplanin, Ambisone and or Vancomycin was recorded. Finally, we observed that PCT reversed to normal values when CMV reactivation was documented (4/23 pts, 17%). In conclusion, our preliminary data show that PCT is a new, reliable and rapid test, helpful to discriminate bacterial e/o fungal versus viral infections. In the peculiar subset of highly compromised pts such those who underwent high dose chemotherapy PCT could be adopted as adjunctive test to monitor the effectiveness of the administered antibiotic therapy.
Full conference title:
43rd American Society of Hematology (ASH) Annual Meeting
- ASH 43rd (2001)