Clusterin and pentraxin 3 are markers of severity during febrile neutropenia in adults with haematological malignancies receiving intensive chemotherapy.

The identification of predictive biomarkers of severity can improve patient management because febrile neutropenia can be associated with significant morbidity and mortality. We prospectively studied pentraxin 3 (PTX3), a soluble innate immunity receptor, and clusterin (CLU), a chaperone protein that binds extracellular histones during sepsis, in patients experiencing febrile neutropenia after intensive treatment for haematological malignancies. One hundred and forty-three adult patients were included, with 158 episodes of neutropenia analysed. Febrile neutropenia was observed in 119 patients (75%), including 62 without sepsis (group 1; 53%), 42 with sepsis (group 2; 35%) and 14 with severe sepsis/septic shock (group 3; 12%) (missing data, MD): (1) Among these patients, 94 patients had a quick Sequencial Organ Failure Assessment score (qSOFA) <2 (84%) and 18 had qSOFA ≥2 (16%) (MD: 7). PTX3 levels increased significantly more in group 3 than in group 1 (p = 0.009). CLU levels tended to decrease after fever more in patients with qSOFA ≥2 than in those with qSOFA <2 and more in patients in group 3 than in group 1 but without a significant difference. PTX3 and CLU could be biomarkers of severity in patients with febrile neutropenia in adults. Their use to tailor the initial management of febrile neutropenia should be prospectively evaluated.