title: Pretransplant C-reactive protein as A prognostic marker in allogeneic stem cell transplantation.
abstract: We evaluated the prognostic role of baseline levels of C-reactive protein (CRP) as well as CRP levels during conditioning in patients undergoing myeloablative allogeneic stem cell transplantation (SCT). Furthermore, we studied the impact of baseline clinical factors and conditioning regimens on CRP levels in the same period. We conducted a population-based retrospective study of 349 patients undergoing SCT at the National Danish SCT centre between January 2000 and January 2009. CRP levels increased significantly during the conditioning and peaked at day -3 before infusion of the graft. Elevated CRP was associated with older age, non-malignant disease, reduced pretransplant Karnofsky score and high-risk leukaemia. By univariate and multivariate analyses, increased CRP levels (>10 mg/l) before the start of treatment (day -7) and at the day of graft infusion (day 0) were associated with decreased overall survival [HR 1.35 (95%CL) (1.18-1.54); P < 0.0001] and increased treatment-related mortality [1.5 (1.24-1.82); P < 0.0001]. Similar findings were seen for mean CRP levels during the conditioning. CRP was not associated with risk of relapse or aGvHD in multivariate analysis. This study suggests that increased CRP levels before and during the conditioning are associated with baseline clinical factors and that elevated pretransplant CRP levels predict a poorer survival in SCT.
authors: Department of Pediatric and Adolescent Medicine 4072 and Institute for Inflammation Research 7541, National University Hospital, Rigshospitalet, Copenhagen, Denmark.
authors: K K I
authors: KK
authors: Jordan
authors: I J
authors: IJ
authors: Christensen
authors: C
authors: C
authors: Heilmann
authors: H
authors: H
authors: Sengeløv
authors: K G
authors: KG
authors: Müller
mesh_terms: D000293:Adolescent; D000328:Adult; D002097:C-Reactive Protein / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D007223:Infant; D007249:Inflammation / Q000378:metabolism; D007938:Leukemia / Q000378:metabolism / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D019653:Myeloablative Agonists / Q000627:therapeutic use; D011379:Prognosis; D012189:Retrospective Studies; D033581:Stem Cell Transplantation / Q000379:methods*; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous / Q000379:methods; D055815:Young Adult
chemical_list: D019653:Myeloablative Agonists; D002097:C-Reactive Protein