Level of Pentraxin-3 in Patients with Acute Leukemia in Septicemia and Its Prognostic Value

Abstract

Introduction: In acute leukemia, sepsis is potentially fatal. Pentraxin3 is a protein rapidly produced in response to primary inflammatory signals. It shows high levels in sepsis, specially associated with vascular and end-organ damage. Aim of the Work: To measure the level of PTX3 in sepsis in patients with acute leukemia and correlate its level to higher risk of complications compared with CRP. Study Design: Prospective study. Place and Duration of the Study: Department of hematology, Alexandria main university hospital, from April 2012 to August 2013. Methods: The study included 60 patients, they had routine workup for leukemia. Serum CRP and plasma PTX3 levels were measured with ELISA on days 1, 2, 3 of febrile neutropenia after chemotherapy. Results: Male to female ratio 1:1, age ranged from 18 to 62 years (median of 40 yrs). 41 patients suffered from acute myeloid leukemia, and 19 from acute lymphoblastic leukemia. High PTX3 levels on the 1st day of sepsis have been a strong indicator for development of complications (septic shock and mortality) (P=.001) compared to CRP (P=.032). High PTX3 level has been associated with coagulation impairment (P=.001). PTX3 showed sensitivity of 100% and specificity of 70% for prediction of bad prognosis, whereas CRP showed sensitivity of 88.5% and specificity of 60.5%. Conclusion: PTX3 is highly recommended in diagnosis of sepsis in patients with acute leukemia during neutropenia and it shows high sensitivity and specificity in prediction of bad prognosis (septic shock, coagulation impairment and mortality) in comparison with CRP.