ABSTRACT

Background:

C-reactive protein (CRP) is an acute phase protein (APP) and has prognostic significance in multiple myeloma (MM). Procalcitonin (PCT) is also an APP and has been reported to be elevated in patients with severe systemic infection and sepsis. Aims: We investigated PCT level in patients with MM and its relationship with the stage and activity of the disease. The discriminatory value of PCT level in myeloma patients with and without infection was also assessed.

Patients and methods:

PCT, CRP, interleukin-6 (IL-6) and IL-1β levels were determined in 69 blood samples from 66 myeloma patients with various disease activity and 25 controls. Infections were verified by microbiological identification of an infectious specimen together with clinical presentation and radiological findings. Statistical analysis: The Mann-Whitney U test and Spearman’s rank correlation test were performed. P values lower than 0.05 were considered significant.

Results:

Patients with known infections and inflammatory diseases that might elevate PCT levels were excluded from the data in order to evaluate PCT merely in MM. None of the patients with MM had a PCT level higher than 0.5 ng/mL. Mean PCT level in myeloma patients with infection, without infection and controls were 1.42±0.36, 0.38±0.15 and 0.09±0.02, respectively. The difference between mean PCT levels in myeloma patients with and without infection was insignificant (p>0.05). The sensitivity of PCT for the detection of infection was 64%, and the specificity 82%.

Conclusion:

PCT level seems to be a good parameter to identify systemic bacterial infections and is a useful marker of the severity of infection in patients with MM if coexistent non-infectious conditions that may contribute to PCT elevation are excluded by appropriate clinical and laboratory investigations.