• Shin Ahn, Yoon-Seon Lee, Kyung Soo Lim, and Jae-Lyun Lee.
• Cancer Emergency Room, Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Pungnap-dong, Songpa-gu, Seoul, 138-736, South Korea. ans1023@gmail.com
• Support Care Cancer. 2013 Aug 1; 21 (8): 2303-8.

PurposeInfectious complication could be life-threatening in patients with chemotherapy-induced febrile neutropenia (FN). The Multinational Association of Supportive Care in Cancer (MASCC) risk-index score is used to predict the complications of these patients, and it has been focused on identifying low-risk patients who may be candidates for outpatient management. In this study, we evaluated procalcitonin (PCT) and the MASCC score in predicting bacteremia and septic shock in patients with FN.MethodsFrom November 2010 to October 2011, 355 patients with FN were prospectively enrolled. Clinical and laboratory findings, including procalcitonin, and the MASCC score were analyzed and correlated with the infectious complications of FN.ResultsOf the 355 patients, 35 (9.9 %) had bacteremia, and 25 (7.0 %) developed septic shock. PCT ≥ 0.5 ng/mL (OR 3.96, 95 % CI 1.51-10.40), platelet count <100 × 10(3)/mm(3) (OR 2.50, 95 % CI 1.10-5.66), and MASCC score <21 (OR 2.45, 95 % CI 1.03-5.85) were independently predictive of bacteremia, and PCT ≥ 1.5 ng/mL (OR 29.78, 95 % CI 9.10-97.39) and MASCC score <21 (OR 9.46, 95 % CI 3.23-27.72) were independent factors of septic shock. In 306 patients with low-risk FN classified by the MASCC score, 52 had PCT ≥ 0.5 ng/mL and 31 had PCT ≥ 1.5 ng/mL. Of the 52 patients with PCT ≥ 0.5 ng/mL, 12 (23.1 %) had bacteremia, and of the 31 patients with PCT ≥ 1.5 ng/mL, 7 (22.6 %) developed septic shock.ConclusionImplicating PCT as a routine use in clinical practice along with the MASCC score could improve risk stratification of patients with FN.

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