Download European Respiratory Society Annual Congress 2013

European Respiratory Society
Annual Congress 2013
Abstract Number: 1373
Publication Number: P4400
Abstract Group: 10.1. Respiratory Infections
Keyword 1: Biomarkers Keyword 2: Infections Keyword 3: Immunosuppression
Title: Utility of biomarkers in the management of respiratory diseases in hematopoietic stem cell transplant
Dr. Carmen Mª 11370 Lucena [email protected] MD 1, Dr. Montserrat 11371 Rovira
[email protected] MD 2, Dr. Xavier 11372 Filella [email protected] MD 3, Ms. Rebeca 11373 Domingo
[email protected] 1, Prof. Dr Antoni 11374 Torres [email protected] MD 1 and Dr. Carlos 11406
Agustí [email protected] MD 1. 1 Respiratory, Hospital Clínic, Barcelona, Spain ; 2 Hematology, Hospital
Clínic, Barcelona, Spain and 3 Biochemical, Hospital Clínic, Barcelona, Spain .
Body: Rationale Different biomarkers have shown utility in the management of infectious diseases in
immunocompetent patients; however its role in hematopoietic stem cell transplant (HSCT) remains
controversial. The aim of this study was to investigate the value of biomarkers in the management of
respiratory complications (RC) in HSCT recipients. Methods We conducted a prospective observational
study. A cohort of 175 patients was follow-up for 1 year after HSCT. A total of 62 RC were identified.
C-reactive protein (CRP), pro-adrenomedullin (pro-ADM) and procalcitonin (PCT) were measured within the
first 24-48 hours after the identification of the RC. Results Forty-six episodes (74%) were respiratory
infections and 16 (26%) were non-infectious complications. Table 1 shows CRP, pro-ADM and PCT values
in the different groups studied. Patients dying of the RC had levels of pro-ADM and PCT (but not CRP)
significantly higher than those who survived [(4.7±3.8 vs 2.6±2.3 nmol/L, p=0.05) and (15.1±22.6 vs 1.9±5.5
ng/mL, p=0.03), respectively)]. PCT was the biomarker that presented the best area under de curve, in the
ROC analysis: 0.78, 95% CI 0.64-0.92, p=0.003.
CRP
pro-ADM
PCT
Mean±SD (mg/dl)
p
Mean±SD (nmol/L)
p
Mean±SD (ng/mL)
p
Non-infections
15.2±8.9
NS
4.7±3.6
NS
3.4±6.2
NS
Infections
10.9±9.2
Bacterial infections
12.9±10
Viral infections
7.9±8.2
2.7±2.6
NS
4.5±3.8
1.6±1
6.7±16.1
0.032
18.5±26.1
0.045
0.4±0.5
Conclusions Alhough biomarkers can not differentiate between respiratory infections and non-infectious
episodes; they can be useful tools for differentiating bacterial from viral infections. PCT value on admission
is a good prognostic marker in HSCT-recipients with RC.