Relationship between procalcitonin serum levels and complications and outcome of patients with hematological malignancy admitted to Intensive Care Unit

Background and objective: Patients with hematological neoplasms transferred to an Intensive Care Unit (ICU) for a life-threatening complication have a poor outcome. In these patients, it is crucial to identify clinical and biologic parameters with potential prognostic significance. This study prospectively evaluated the usefulness of serum procalcitonin (PCT) levels as a predictor of complications (infectious or not) and outcome in these patients. Patients and method: One hundred patients with hematological malignancy were admitted to the ICU from October 2004 until August 2009. In 59 of them serum PCT levels were daily measured from the ICU admission until a maximum period of 10 consecutive days. Results: Hematological diseases were acute leukemia (n = 30), lymphoma and other lymphoproliferative disorders (n = 18), multiple myeloma (n = 7) and other (n = 4). Twenty-five patients (42%) had received hematopoietic stem cell transplantation. Thirty-seven patients (63%) presented neutropenia. Those patients who could not be discharged alive from the ICU presented higher PCT levels on days 1, 2 and 3. PCT levels were significantly higher in those patients with neutropenia or septic shock or other causes of hemodynamic instability. The presence of a microbiologically documented infection, respiratory failure or the need of mechanical ventilation support did not significantly affect PCT levels in this study. Conclusions: Early serum PCT levels measurement might be useful for predicting mortality in patients with hematological malignancy requiring advanced life support. (C) 2011 Elsevier Espana, SI. All rights reserved.