title: Early elevation of C-reactive protein correlates with severe infection and nonrelapse mortality in children undergoing allogeneic stem cell transplantation.
abstract: C-reactive protein (CRP) is an acute phase reactant that is a reliable marker of systemic inflammation and has been associated with increased morbidity and mortality following hematopoietic stem cell transplantation (HSCT) in adults. In this study, we evaluated whether early elevations of CRP were associated with various complications and nonrelapse mortality following HSCT in pediatric patients. Seventy pediatric patients had CRP levels drawn at regular time points during the first week following their transplants. Patients were followed for 100 days following transplant, and transplant-related complications were documented. Patients who subsequently developed severe infections had higher median CRP values than those without severe infections (median 8.03 mg/dL versus 1.64 mg/dL, P = .0008) as did those who suffered nonrelapse mortality compared with those who did not (12.6 mg/dL versus 2.44 mg/dL, P = .02). These findings suggest that elevated CRP values may be useful as a marker of individual pediatric patients with a higher risk for treatment-related morbidity and mortality.
authors.affiliation: Department of Pediatrics, Section of Hematology/Oncology, University of Chicago, Chicago, Illinois, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: McNeer
authors.forename: Morris
authors.initials: M
authors.lastname: Kletzel
authors.forename: Alfred
authors.initials: A
authors.lastname: Rademaker
authors.forename: Kavita
authors.initials: K
authors.lastname: Alford
authors.forename: Kathleen
authors.initials: K
authors.lastname: O'Day
authors.forename: Colleen
authors.initials: C
authors.lastname: Schaefer
authors.forename: Reggie
authors.initials: R
authors.lastname: Duerst
authors.forename: David A
authors.initials: DA
authors.lastname: Jacobsohn
mesh_terms: D000293:Adolescent; D000328:Adult; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D003141:Communicable Diseases / Q000097:blood* / Q000150:complications / Q000401:mortality*; D005260:Female; D006086:Graft vs Host Disease / Q000097:blood / Q000175:diagnosis; D006402:Hematologic Diseases / Q000097:blood / Q000628:therapy; D019337:Hematologic Neoplasms / Q000097:blood / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000401:mortality*; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000097:blood* / Q000401:mortality*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012372:ROC Curve; D012307:Risk Factors; D012737:Sex Factors; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D055815:Young Adult
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein