Abstract: Background and purpose: Previous researches have shown that procalcitonin differentiates infectious from non-infectious fever and assesses the severity of infectious diseases. This study aimed to investigate the clinical value of procalcitonin in patients with chemotherapy-induced febrile neutropenia. Methods: A total of 147 patients with chemotherapy-induced febrile neutropenia admitted to intensive care unit from Jan. 2012 to Dec. 2014 were divided into infectious group and fever of unknown origin group according to clinical symptoms, signs and etiology. The infectious group was divided into sepsis, severe sepsis, and septic shock groups according to the severity of infection. The procalcitonin levels were compared between different groups. Results: A procalcitonin cut-off value>0.935 ng/mL provided a sensitivity of 90.0%, specificity of 90.0% and AUC=0.905. The procalcitonin level of the infectious group was significantly higher than that of the fever of unknown origin group [1.805 (1.268-2.523) ng/mL vs 0.555 (0.398-0.818) ng/mL, P<0.001]. There is a significant difference between the severe sepsis group and the sepsis group [13.885 (7.600-17.961) ng/mL vs 1.805 (1.268-2.563) ng/mL, P<0.001]. Compared with the severe sepsis group, the value of procalcitonin in the septic shock group was significantly higher [23.800 (20.050-30.478) ng/mL vs 13.885 (4.955-19.133) ng/mL, P<0.001]. Conclusion: Plasma procalcitonin is a useful marker for diagnosing neutropenia in patients with infection. Meanwhile, procalcitonin can be used to assess the severity of infection in patients with neutropenia.

Key words: Procalcitonin, Neutropenia, Cancer chemotherapy, Fever