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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.