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Experts Recommend Against Serum PCT as Biomarker in Ph-Negative MPNs

Study findings have led experts to recommend against the use of serum procalcitonin (PCT) as a disease biomarker in patients with myeloproliferative neoplasms (MPNs; Wien Klin Wochenschr. 2021;133[1-2]:62-64).

“Non-hematologists sometimes (and often wrongly) consider the fever in MPN patients to be a symptom of an underlying disease, which may have devastating consequences,” wrote lead investigator Ivan Krečak, MD, Department of Internal Medicine, General Hospital of Šibenik-Knin County, Croatia, and colleagues.

“Serum [PCT] is a circulating biomarker commonly used to improve the diagnostic accuracy of bacterial infections and to guide antibiotic therapy,” they continued.

Thus, to determine whether PCT could help with the early diagnosis of bacterial infections in patients with Philadelphia chromosome-negative MPNs, Dr Krečak et al conducted a study comparing 41 ambulatory patients with MPN who had no signs of infection with 10 patients with MPN and bacterial infections.

The median PCT was determined to be 0.02 ng/mL, and no differences were observed in PCT whether patients had essential thrombocythemia (ET), polycythemia vera (PV), or myelofibrosis (MF; P = .993).

However, patients with MPN and bacterial infections had significantly higher PCT (median PCT, 2.45) than those MPN patients with (median PCT, 0.03 ng/mL) or without (median PCT, 0.02 ng/mL) constitutional symptoms (P <.001).

According to the investigators, these findings do not recommend the use of PCT as a disease biomarker in MPNs, and suggest that careful clinical assessment is needed for signs of infection when patients with MPN present with fever and high PCT.—Hina Porcelli

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