Serum amino-terminal pro-brain natriuretic peptide in hematological patients with neutropenic fever: a prospective comparison with C-reactive protein

Abstract

Serum amino-terminal pro-brain natriuretic peptide (NT-proBNP) is considered as a prognostic marker in patients with severe sepsis or septic shock, but no data are available on NT-proBNP kinetics in hematological patients with neutropenic fever. Altogether 70 hematological patients with neutropenic fever were included in this prospective study. NT-proBNP and C-reactive protein (CRP) were determined at the beginning of the neutropenic fever (d0) and then daily up to 3–4 days. The median NT-proBNP (interquartile range) increased from 127 (57–393) ng/L on d0 to 542 (194–1385) ng/L on d4. The increment of CRP was from 35 (17–61) mg/L on d0 to 109 (56–109) mg/L on d2. Neither serial NT-proBNP nor CRP predicted development of severe sepsis, but NT-proBNP was significantly higher in patients with previous cardiovascular disease than in those without. NT-proBNP seemed to reflect cardiac distress, but it did not help to predict the development of severe sepsis in this patient group.

Keywords:

• N-terminal pro-BNP
• C-reactive protein
• neutropenic fever
• severe sepsis
• hematological patients

Declaration of Interest: The study was financially supported by an EVO grant of Kuopio University Hospital and the Finnish Cultural Foundation.