Philadelphia-negative myeloproliferative neoplasms (MPNs), essential thrombocythemia (ET), polycythemia vera (PV), and myelofibrosis (MF), are rare clonal hematopoietic stem cell disorders accompanied by a strong inflammatory milieu, which is directly responsible for constitutional symptoms associated with the disease, such as fever, weight loss or night sweats. Non-hematologists sometimes (and often wrongly) consider the fever in MPN patients to be a symptom of an underlying disease, which may have devastating consequences. Serum procalcitonin (PCT) is a circulating biomarker commonly used to improve the diagnostic accuracy of bacterial infections and to guide antibiotic therapy. The aim of this study was to test whether PCT could aid the clinician in the early diagnosis of bacterial infections in MPNs. This study investigated PCT in 41 ambulatory MPN patients (13 ET, 13 PV and 15 MF) who had no signs of infection and compared it to 10 MPN patients with microbiologically and/or serologically documented bacterial infections. Median PCT in MPN patients was 0.02 ng/mL (range 0.01–0.09 ng/mL). No difference in PCT was found between ET, PV and MF patients (p = 0.993), whereas MPN patients with documented bacterial infections had significantly higher PCT (median PCT 2.45, range 0.90–5.40 ng/mL) when compared to MPN patients with (median PCT 0.03 ng/mL) or without constitutional symptoms (median PCT 0.02 ng/mL; p < 0.001 for both analyses). These results clearly show that PCT should not be considered as a disease biomarker in MPNs and careful clinical assessment for the signs of infection is needed when MPN patients present with fever and high PCT.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Geyer HL, Dueck AC, Scherber RM, Mesa RA. Impact of inflammation on myeloproliferative neoplasm symptom development. Mediators Inflamm. 2015;2015:284706.
Barbui T, Carobbio A, Finazzi G, et al. Inflammation and thrombosis in essential thrombocythemia and polycythemia vera: different role of C‑reactive protein and pentraxin 3. Haematologica. 2011;96(2):315–8.
Lee H. Procalcitonin as a biomarker of infectious diseases. Korean J Intern Med. 2013;28(3):285–91.
Delèvaux I, André M, Colombier M, et al. Can procalcitonin measurement help in differentiating between bacterial infection and other kinds of inflammatory processes? Ann Rheum Dis. 2003;62(4):337–40.
Shomali W, Hachem R, Chaftari AM, et al. Can procalcitonin distinguish infectious fever from tumor-related fever in non-neutropenic cancer patients? Cancer. 2012;118(23):5823–9.
Arber DA, Orazi A, Hasserjian R, et al. The 2016 revision to the World Health Organization classification of m y e l o i d neoplasms and acuteleukemia. Blood. 2016;127:2391–405.
Kralovics R, Passamonti F, Buser AS, et al. A gain-of-function mutation of JAK2 in myeloproliferative disorders. N Engl J Med. 2005;352(17):1779–1790.
Schüttrumpf S, Binder L, Hagemann T, Berkovic D, Trümper L, Binder C. Procalcitonin: a useful discriminator between febrile conditions of different origin in hemato-oncological patients? Ann Hematol. 2003;82(2):98–103.
Gac AC, Parienti JJ, Chantepie S, et al. Dynamics of procalcitonin and bacteremia in neutropenic adults with acute myeloid leukemia. Leuk Res. 2011;5(10):1294–6.
Kim DY, Lee YS, Ahn S, Chun YH, Lim KS. Procalcitonin as a useful marker of infection in hematooncological patients with fever. Cancer Res Treat. 2011;43(3):176–80.
Stölzel F, Babatz J, Thiede C, Siegert G, Illmer T, Ehninger G, et al. Cyclic severe elevated procalcitonin serum levels in patient with post polycythemic myelofibrosis carrying a V617F-JAK2 mutation. Ann Hematol. 2008;87(12):1021–2.
Conflict of interest
I. Krečak, N. Peran, I. Lapić, V. Gverić-Krečak, F. Krečak, P. Rončević, and N. Duraković declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Krečak, I., Peran, N., Lapić, I. et al. Serum procalcitonin in Philadelphia-negative myeloproliferative neoplasms. Wien Klin Wochenschr 133, 62–64 (2021). https://doi.org/10.1007/s00508-020-01651-8
- Essential thrombocythemia
- Polycythemia vera