C-reactive protein serum level is a valuable and simple prognostic marker in non Hodgkin's lymphoma.
Interleukin-6 plays a central role in normal B-cell maturation and in proliferation of some B-cell malignancies including multiple myeloma and some non Hodgkin's lymphomas (NHL). Furthermore, this cytokine also plays a major role in acute phase response by mediating synthesis of acute phase proteins such as C-reactive protein (CRP). In order to evaluate the exact role of CRP serum level as a simple prognostic factor, we analyzed CRP and IL-6 serum levels in 39 patients with NHL. Eleven patients had low grade NHL, 15 intermediate grade NHL, and 13 high grade NHL. Thirty percent of the patients presented detectable IL-6 serum levels (mean+/-SD: 33.6+/-95.2 U/ml, range: 0 to 500). Increased serum CRP levels were found in 42% of the patients with a mean of 29.2+/-41.97 mg/l] (range: 0 to 129). Thirty seven patients were studied for both markers. Three groups of patients were determined. One with low IL-6 and CRP serum levels (N=21), a second with high level of both markers (N=10), and the third with high serum CRP levels alone (N = 5). Only one patient had high level of serum IL-6 with no detectable CRP. The correlation of serum IL-6 and CRP levels with patient survival was investigated. Median survival in the group with low IL-6 level was not reached. 67% of patients of this group were still alive at 32 months from diagnosis. The group of patients with detectable IL-6 had a median of survival of 12 months (p<0.025). The survival of patients with a CRP<10 mg/l was not reached. 75% of patients survive at 32 months from diagnosis, whereas the group with higher CRP level reached a median survival at 8.5 months (p<0.009). As expected, on univariate analysis, there is a significant relationship between CRP and IL-6 levels (p<0.00017), and CRP levels and B symptoms (p<0.001). Furthermore there is a significant relationship between CRP and LDH levels (p<0.042).These results indicated that CRP may be considered as a valuable and easy prognostic biomarker of NHL.
Legouffe
E
E
Service d'hematologie-oncologie, Unité de greffe de moelle et d'immunothérapie des cancers, C.H.U. Lapeyronie, Montepellier, France.
Rodriguez
C
C
Picot
M C
MC
Richard
B
B
Klein
B
B
Rossi
J F
JF
Commes
T
T
D014408:Biomarkers, Tumor; D002097:C-Reactive Protein / Q000032:analysis*; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D008228:Lymphoma, Non-Hodgkin / Q000097:blood* / Q000276:immunology / Q000473:pathology; D011379:Prognosis
D014408:Biomarkers, Tumor; D015850:Interleukin-6; D002097:C-Reactive Protein