title: [Value of C-reactive protein level on transplantation day in predicting early post-transplant infections and outcomes of allogeneic hematopoietic stem cell transplantation].
abstract: OBJECTIVE
  To investigate the value of C-reactive protein (CRP) on transplantation day in predicting early post-transplant infections and outcomes of allogeneic hematopoietic stem cell transplantation (allo-HSCT).
  
  
  METHODS
  We retrospectively analyzed the clinical data of 78 recipients undergoing allo-HSCT. The clinical reference value of CRP on transplantation day was determined, and its sensitivity and specificity for diagnosing bacteremia was analyzed using receiver-operating characteristic curve (ROC). The incidence of transplant-related complications, overall survival, and relapse rate of the patients were analyzed with respect to the CRP level.
  
  
  RESULTS
  The clinical reference value of CRP for diagnosing bacteremia was 23.3 mg/L (AUC=0.735 [95% CI: 0.623-0.848], P=0.001), which had a diagnostic sensitivity and specificity of 0.793 and 0.592, respectively. Compared with the patients with low CRP levels, the patients with high CRP levels tended to have delayed neutrophil reconstitution and platelet engraftment by 0.71 days (P=0.237) and 4.09 days (P=0.048), respectively, and had a significantly higher incidence of bacteremia (17.1% vs 53.5%, P=0.001) and CMV viremia (37.1% vs 72.1%, P=0.003) within 100 days following the transplantation; the incidences of EBV viremia, pulmonary invasive fungal infection, or acute graft versus host disease (aGVHD) showed no significant difference between the two groups (41.9% vs 22.9%, P=0.094; 14.0% vs 5.7%, P=0.285; 51.2% vs 45.7, P=0.656, respectively). During the follow-up for a median of 318 (7-773) days in high-CRP group and for 299 (78-747) days in low-CRP group, the high-CRP group showed a significantly lower 2-year overall survival than the low-CRP group (42.5% vs 78.4%, P=0.022), and tended to have a higher 2-year cumulative relapse rate (52.3% vs 19.8%, P=0.235). Logistic multivariate analysis identified a high CRP level on transplantation day as the independent risk factor for post-transplant bacteremia within 100 days (OR=5.090 [95% CI: 1.115 -23.229], P=0.036).
  
  
  CONCLUSIONS
  A high CRP level on transplantation day can be indicative of a high risk of early post-transplant bacteremia and CMV viremia and also a poor prognosis following allo-HSCT.
authors.affiliation: Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.E-mail: skf-1105@163.com.
authors.forename: Kefeng
authors.initials: K
authors.lastname: Shen
authors.forename: Qifa
authors.initials: Q
authors.lastname: Liu
authors.forename: Jing
authors.initials: J
authors.lastname: Sun
authors.forename: Qianli
authors.initials: Q
authors.lastname: Jiang
authors.forename: Yu
authors.initials: Y
authors.lastname: Zhang
authors.forename: Hongsheng
authors.initials: H
authors.lastname: Zhou
authors.forename: Min
authors.initials: M
authors.lastname: Dai
authors.forename: Min
authors.initials: M
authors.lastname: Xiao
authors.forename: Jin
authors.initials: J
authors.lastname: Wang
authors.forename: Li
authors.initials: L
authors.lastname: Luo
authors.forename: Qinlu
authors.initials: Q
authors.lastname: Li
authors.forename: Haiyun
authors.initials: H
authors.lastname: An
authors.forename: Zhen-Ya
authors.initials: ZY
authors.lastname: Hong
authors.forename: Li
authors.initials: L
authors.lastname: Meng
authors.forename: Mo
authors.initials: M
authors.lastname: Yang
authors.forename: Jianfeng
authors.initials: J
authors.lastname: Zhou
authors.forename: Gaoxiang
authors.initials: G
authors.lastname: Wang
mesh_terms: D016470:Bacteremia / Q000175:diagnosis*; D002097:C-Reactive Protein / Q000737:chemistry*; D006086:Graft vs Host Disease; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015994:Incidence; D009181:Mycoses; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014766:Viremia / Q000175:diagnosis*
chemical_list: D002097:C-Reactive Protein