Babel, J.; Košuta, I.; Vujaklija Brajković, A.; Lončar Vrančić, A.; Premužić, V.; Rogić, D.; Duraković, N. Early Fever in Allogeneic Stem Cell Transplantation: Are Presepsin and YKL-40 Valuable Diagnostic Tools?. Preprints2024, 2024090518. https://doi.org/10.20944/preprints202409.0518.v1
APA Style
Babel, J., Košuta, I., Vujaklija Brajković, A., Lončar Vrančić, A., Premužić, V., Rogić, D., & Duraković, N. (2024). Early Fever in Allogeneic Stem Cell Transplantation: Are Presepsin and YKL-40 Valuable Diagnostic Tools?. Preprints. https://doi.org/10.20944/preprints202409.0518.v1
Chicago/Turabian Style
Babel, J., Dunja Rogić and Nadira Duraković. 2024 "Early Fever in Allogeneic Stem Cell Transplantation: Are Presepsin and YKL-40 Valuable Diagnostic Tools?" Preprints. https://doi.org/10.20944/preprints202409.0518.v1
Abstract
(1) Background: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a lifesaving treatment but carries a high infection risk. Diagnosing infections remains challenging due to the limited accuracy of standard biomarkers. (2) Methods: This single-center study aimed to evaluate presepsin (PSP) and YKL-40 as infection biomarkers in febrile patients during the allo-HSCT pre-engraftment phase. Biomarker levels were prospectively measured in 61 febrile episodes from 54 allo-HSCT patients at admission, representing baseline levels and then at Day 1, 3, 5, and 7 following fever onset. The diagnostic value was compared to that of procalcitonin (PCT). (3) Results: PSP showed fair diagnostic value on Day 1 (AUC 0.656; 95% CI: 0.510 – 0.802) and Day 3 (AUC 0.698; 95% CI: 0.559 – 0.837). YKL-40 did not provide any significant diagnostic value across measured time points. PCT outperformed PSP and YKL-40, particularly on Day 3 (AUC 0.712; 95% CI: 0.572 – 0.852). When combining biomarkers, the best model for predicting infection used PSP > 3.144 ng/mL and PCT > 0.28 g/L on Day 3, resulting in R2 of about 31% (p < 0.001). (4) Conclusion: Neither test showed sufficient discriminative power for early infection to recommend their use as individual diagnostic tools in clinical practice.
Keywords
bone marrow transplantation; hematopoietic stem cell transplantation; chitinase-3-like protein 1; YKL-40 protein; human; presepsin protein; human; procalcitonin
Subject
Medicine and Pharmacology, Clinical Medicine
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
