PONE-D-19-16377

Serum procalcitonin as an independent diagnostic markers of bacteremia in febrile patients with hematologic malignancies

PLOS ONE

Dear Dr. Oh,

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PLOS ONE

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This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIP) (NRF-2017R1A2B4011181), Republic of Korea.The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Partly

Reviewer #2: Partly

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: No

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The manuscript of Dr. Eun-Jee Oh. and its group by `` Serum procalcitonin as an independent diagnostic markers 1 of bacteremia in febril patients with hematologic malignancies` entitle was studied.

- The subject and experiment design was good.

Some question in manuscript should be answered:

1- What is the mechanism of infection or fever to induce increase of PCT level?

2- Fever is responsible to increase serum level of PCT or PCT is responsible for fever?

3- However, usually patients with malignant hematopoiesis disorder have fever and immune system of this kind of patient is not effective, therefore infection is as usual. May be the cause of increase serum level of PCT, were not be related to malignant hematopoiesis disorder.

The Authors find that the PCT serum level increase by malignant hematopoiesis disorder or transplantation, here we should consider to some question:

a- In other malignancies what is happened for PCT? It has been necessary to have data from other malignancy and discusses about that.

b- Is it possible PCT would be prognosis factor or treatment evaluated factor?

The discussion should be more and improve.

Reviewer #2: The authors present an analysis of a large patient cohort with haematological diseases focusing on infection monitoring with laboratory test such as CRP and PCT in addition to microbiological examinations. However, the presentation of the data in its current form is poor, lacks clarity, important details and interpretation.

Major:

1. It should be elaborated if there are overlaps between patients with hematology diagnosis and those that were treated by HSCT. What were the typical diagnoses for HSCT?

2. More details should be provided about viral infections and non-infectious etiology: lines 145 and 146.

3. Statements of lines 163 and 164 do not correspond with the numbers of Table 2.

4. Figure legends in general must be substantially extended with additional details e.g. case numbers in the respective subgroups, rational and method of subgrouping, statistics employed etc. I do not clearly understand the difference between Figs 1 and 2, similarly the meaning of colour is also missing.

5. In addition to the above deficiencies, in the context of Fig 5 (lines 239 through 248), respective case numbers are missing. There is an apparent discrepancy between CRP differences in earlier comparisons and the apparent similarities in these comparisons.

6. The abstract should be completely rewritten. For me the line of study is unclear. In my opinion a single observation is arbitrarily emphasized as conclusion.

Minor: potential points of grammatical improvements

1. Table 1 should be omitted, it is redundant relative to Table 2

2. In Table 2 ANC value (median) <0.01 is unlikely to be correct for Bacteriemia pos pts

3. Table 2 abbreviations should be in alphabetical orde

4. English proficiency should be further improved. Even myself, a non-English native, found several incorrectly worded phrases.

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Reviewer #1: No

Reviewer #2: No

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Serum procalcitonin as an independent diagnostic markers of bacteremia in febrile patients with hematologic malignancies

PONE-D-19-16377R1

Dear Dr. Oh,

We are pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it complies with all outstanding technical requirements.

Within one week, you will receive an e-mail containing information on the amendments required prior to publication. When all required modifications have been addressed, you will receive a formal acceptance letter and your manuscript will proceed to our production department and be scheduled for publication.

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With kind regards,

Senthilnathan Palaniyandi, Ph.D

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #2: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #2: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #2: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #2: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #2: The questions raised have been adequately answered and appropriate modifications have bben made to the text.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #2: No