Role of procalcitonin and C-reactive protein for discrimination between tumor fever and infection in patients with hematological diseases.

Tumor fever is a common complication in patients with hematological malignancies. We retrospectively analyzed the levels of C-reactive protein (CRP) and procalcitonin (PCT) in patients with lymphoid malignancies and fever that was attributed to tumor (39 episodes, group I) or infection (26 episodes, group II) before chemotherapy, and bloodstream infection (26 episodes, group III) after chemotherapy. The PCT level and PCT/CRP ratio were significantly higher in groups II and III than in group I (p = 0.003, p = 0.0005, respectively for groups II and I, and p = 0.003, p = 0.00002, respectively for groups III and I). At the cut-off level of 0.071 or 0.014 for PCT/CRP, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of PCT/CRP were 53.8% or 96.2%, 89.7% or 53.8%, 77.8% or 58.1% and 74.5% or 95.5%, respectively, for discrimination between groups I and II or groups I and III. PCT/CRP ratio was the best marker for discrimination between tumor fever and infection.