Evolution of procalcitonin, C‐reactive protein and fibrinogen levels in neutropenic leukaemia patients with invasive pulmonary aspergillosis or mucormycosis

Roques, M.; Chrétien, Marie Lorraine; Favennec, Camille; Lafon, Ingrid; Ferrant, Emmanuelle; Legouge, C.; Plocque, Alexia; Golfier, Camille; Duvillard, Laurence; Neuwirth, Catherine; Bastie, Jean-Noël; Maurin-Bernier, Lory; Dalle, Frédéric; Caillot, Denis

doi:10.1111/myc.12487

Cited by 36 publications

(30 citation statements)

References 30 publications

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“…This study identified, for the first-time, inflammation (assessed by CRP levels) to be a strong independent risk factor of VRC overdose in hematological patients. These data suggest that hematological patients may be at increased risk of supratherapeutic VRC C min and associated toxicity when they exhibit increased CRP levels, which is very frequent for patients with IA [24,25]. Such an elevated CRP level associated risk of VRC overdose is in accordance with several previous studies reporting positive associations between elevated CRP levels and high VRC C min [15,16,[26][27][28][29].…”

Section: R E S U L T Ssupporting

confidence: 90%

“…This study identified, for the first‐time, inflammation (assessed by CRP levels) to be a strong independent risk factor of VRC overdose in hematological patients. These data suggest that hematological patients may be at increased risk of supratherapeutic VRC C min and associated toxicity when they exhibit increased CRP levels, which is very frequent for patients with IA .…”

Section: Discussionmentioning

confidence: 82%

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Inflammation is a potential risk factor of voriconazole overdose in hematological patients

Gautier-Veyret

Truffot

Bailly

et al. 2018

Fundamemntal Clinical Pharma

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Voriconazole (VRC) overdoses are frequent and expose patients at high risk of adverse effects. This case–control study performed in hematological patients who benefited from VRC therapeutic drug monitoring from January 2012 to December 2015 aimed to identify risk factors of VRC overdose. Pharmacogenetic, biological, and demographic parameters at the time of VRC trough concentration (Cmin) were retrospectively collected from medical records. Cases (VRC overdose: defined by a VRC Cmin ≥ 4 mg/L; n = 31) were compared to controls (no VRC overdose: defined by VRC Cmin < 4 mg/L; n = 31) using nonparametric or chi‐square tests followed by multivariable analysis. VRC overdoses were significantly associated with high CRP and bilirubin levels, intravenous administration, and age in univariable analysis. In contrast, the proportion of CYP genotypes (CYP2C19, CYP3A4, or CYP3A5, considered alone or combined in a combined genetic score) were not significantly different between patients who experienced a VRC overdose and those who did not. In multivariable analysis, the class of CRP level (defined by median CRP levels of 96 mg/L) was the sole independent risk factor of VRC overdose (P < 0.01). Patients with CRP levels > 96 mg/L) had a 27‐fold (IC 95%: [6–106]) higher risk of VRC overdose than patients with CRP levels ≤ 96 mg/L. This study demonstrates that inflammatory status, assessed by CRP levels, is the main risk factor of VRC overdose in French hematological patients, whereas pharmacogenetic determinants do not appear to be involved.

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Section: R E S U L T Ssupporting

confidence: 90%

Section: Discussionmentioning

confidence: 82%

Inflammation is a potential risk factor of voriconazole overdose in hematological patients

Gautier-Veyret

Truffot

Bailly

et al. 2018

Fundamemntal Clinical Pharma

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Section: Discussionmentioning

confidence: 85%

“…Second, data on the clinical consequences of VRC overdose in terms of side effects, treatment discontinuation, and efficacy of treatment was absent. This aspect may be particularly important to explore in the future, as studies have already shown that elevated pro-inflammatory cytokine levels are a predictor of poor outcome in invasive aspergillosis (24, 25).…”

Section: Discussionmentioning

confidence: 99%

Inflammation is the main risk factor of voriconazole overdose in hematological patients

Gautier-Veyret

Truffot²,

Bailly

et al. 2018

Preprint

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22Aim: Voriconazole (VRC) overdoses are frequent and expose patients at high risk of adverse effects. 23This case-control study performed in hematological patients who benefited from VRC therapeutic 24 drug monitoring from January 2012 to December 2015 aimed to identify risk factors of VRC 25 overdose. 26Methods: Pharmacogenetic, biological, and demographic parameters at the time of VRC trough 27 concentration (Cmin) were retrospectively collected from medical records. Cases (VRC overdose: 28 defined by a VRC Cmin ≥ 4 mg/l; n = 31) were compared to controls (no VRC overdose: defined by 29 VRC Cmin < 4 mg/L; n = 31) using non-parametric or Chi-square tests followed by multivariable 30 analysis. 31Results: VRC overdoses were significantly associated with high CRP and bilirubin levels, intra-venous 32 administration, and age in univariable analysis. In contrast, the proportion of CYP genotypes 33 (CYP2C19, CYP3A4, or CYP3A5, considered alone or combined in a genetic score 1 ) were not 34 significantly different between patients who experienced a VRC overdose and those who did not. In 35 multivariable analysis, the class of CRP level (defined by median CRP levels of 96 mg/l) was the sole 36 independent risk factor of VRC overdose (p < 0.01). Patients with CRP levels > 96 mg/l had a 27-fold 37 (IC 95%: [6-106]) higher risk of VRC overdose than patients with CRP levels ≤ 96 mg/l. 38Conclusion: This study demonstrates that inflammatory status, assessed by CRP levels, is the main 39 risk factor of VRC overdose in French hematological patients, whereas pharmacogenetic 40 determinants do not appear to be involved. 41 42

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“…But a patient with BKV, CMV infection and invasive aspergillosis had high serum PCT and CRP levels. Roques et al [16] did not observe high PCT levels despite increased CRP levels in leukemia patients with invasive aspergillosis. But Cooper et al [15] found that serum CRP, serum amyloid protein and PCT levels increased significantly in solid-organ transplant patients with fungal infections.…”

Section: Discussionmentioning

confidence: 88%

Correlation of serum C-reactive protein and procalcitonin levels in infections of kidney transplant recipients

Anil

Alp

et al. 2017

The European Research Journal

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Objectives.Procalcitonin is a propeptide of calcitonin and has been increasingly used as a biomarker of infection. The aim of this study was to evaluate correlation of serum C-reactive protein (CRP) and procalcitonin (PCT) levels of kidney transplant patients hospitalized due to infection. Methods. There were 121 patients who had kidney transplant in our center between September 2012 and February 2017 and patients with a diagnosis of infection or rejection were included in the study. Simultaneous 106 serum CRP and PCT levels at the beginning or during any time of treatment for post-transplant infection, cytomegalovirus (CMV) positivity, BK viremia and rejection were evaluated. Results. Median and interquartile ranges of CRP and PCT serum levels were 40 mg/l [24.7-64.9] and 0.19 ng/ml [0.1-0.61], respectively. A significant positive correlation between serum CRP and PCT levels of the patients were observed (r=0.490, p<0.001). When serum CRP levels were grouped as <50 mg/l, 50-100 mg/l and >100 mg/l, correlations with serum PCT levels were as r=0.461 (p<0.001), r=-0.52 (p=0.860) and r=0.488 (p=0.153), respectively. Serum levels of PCT did not increase in CMV and BK virus infections and rejection. Conclusions. Serum CRP and PCT levels were correlated as a whole in the study, whereas serum CRP levels of 50-100 mg/l and >100 mg/l did not show a statistically significant correlation. Stability of PCT levels in viral infections and rejections might be an advantage for the follow-up of solid organ transplants. We need prospective trials of PCT measurements for the evaluation of post-transplant infections.Eur Res J 2017;3(2):135-139

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Evolution of procalcitonin, C‐reactive protein and fibrinogen levels in neutropenic leukaemia patients with invasive pulmonary aspergillosis or mucormycosis

Cited by 36 publications

References 30 publications

Inflammation is a potential risk factor of voriconazole overdose in hematological patients

Inflammation is a potential risk factor of voriconazole overdose in hematological patients

Inflammation is the main risk factor of voriconazole overdose in hematological patients

Correlation of serum C-reactive protein and procalcitonin levels in infections of kidney transplant recipients

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