Procalcitonin as a biomarker for infection-related mortality in cancer patients

Curr Opin Support Palliat Care. 2015 Jun;9(2):168-73. doi: 10.1097/SPC.0000000000000142.

Abstract

Purpose of review: Infectious diseases are the second leading cause of death following direct cancer-related complications in the field of oncology. Clinical studies using the classic inflammatory biomarkers, C-reactive protein, erythrocyte sedimentation rate, leukocytosis, and thrombocytosis fail to show a significant correlation between these biomarkers and infection-related mortality. It is therefore crucial to define new biomarkers that are not affected by the primary cancer and precisely show the severity of the infection to help in the decision-making process.

Recent findings: A significant increase in the number of cancer patients in the past decades has created an exponential increase in the number of immunocompromised patients. Preemptive and typically unnecessary usage of broad-spectrum antibiotics is common during the treatment of these patients and may result in an increase in multidrug-resistant microbial strains. Recent clinical studies suggest that a significant reduction in antibiotic consumption may be achieved by procalcitonin-guided algorithms without sacrificing the outcome of patients with severe infection.

Summary: In this article, we focus on procalcitonin and its potential role in differentiating cancer and infection-induced inflammation. Using this strategy may significantly reduce the usage of empirical broad-spectrum antibiotics and result in earlier discharge of patients.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Anti-Bacterial Agents / adverse effects*
  • Anti-Bacterial Agents / immunology
  • Anti-Bacterial Agents / therapeutic use
  • Bacterial Infections / diagnosis
  • Bacterial Infections / drug therapy
  • Bacterial Infections / mortality*
  • Biomarkers / blood
  • Calcitonin / blood*
  • Calcitonin Gene-Related Peptide
  • Comorbidity
  • Decision Support Systems, Clinical
  • Drug Resistance, Multiple, Bacterial / drug effects
  • Drug Resistance, Multiple, Bacterial / immunology
  • Humans
  • Immunocompromised Host*
  • Neoplasms / drug therapy
  • Neoplasms / microbiology
  • Neoplasms / mortality*
  • Protein Precursors / blood*

Substances

  • Anti-Bacterial Agents
  • Biomarkers
  • CALCA protein, human
  • Protein Precursors
  • Calcitonin
  • Calcitonin Gene-Related Peptide