Increased serum C-reactive protein levels are associated with shorter survival and development of second cancers in chronic lymphocytic leukemia.
Chronic lymphocytic leukemia (CLL) is characterized by a heterogeneous clinical course, ranging from stable to more aggressive disease. Herein, we determined the prognostic significance of serum C-reactive protein (CRP) levels in patients with CLL Methods: A retrospective cohort study reviewing the records of 107 consecutive treatment naïve patients with CLL and a control group comprised of apparently healthy individuals attending for periodic health examinations.



The median CRP level of patients with CLL was 0.19 mg/dL (0-2.9). In univariate analysis, high-CRP levels (≥0.4 mg/dL) were significantly associated with an increased risk of mortality (HR = 3.97, 95%CI 1.64-9.62, p = .002) and development of second solid cancers (HR = 4.54, 95%CI 1.57-13.11, p = .005), compared to low-CRP values (<0.4 mg/dL). In multivariate analysis, high-CRP retained statistical significance for all-cause mortality (HR = 2.81, 95%CI 1.04-7.57, p = .04) and the development of second solid malignancies (HR = 4.54, 95%CI 1.57-13.11, p = .005). Moreover, when compared to an apparently healthy population, CLL patients with high CRP levels had more than an eightfold risk of cancer.



Elevated baseline CRP levels are associated with shorter survival and development of second cancers in patients with CLL. We suggest that increased CRP in patients with CLL may justify a more rigorous search for second cancers. KEY MESSAGES Elevated CRP levels are associated with a shorter overall survival in CLL. Elevated CRP levels are associated with an increased risk of second cancers in CLL. Increased CRP in patients with CLL may justify a more rigorous search for second cancers.
a The Department of Hematology , Tel Aviv Sourasky Medical Center , Tel Aviv , Israel.|b Sackler Faculty of Medicine , Tel Aviv University , Tel-Aviv , Israel.
Yair
Y
Herishanu
c Hebrew University Medical School , Jerusalem , Israel.
Aaron
A
Polliack
d Internal Medicine "C" Tel Aviv Sourasky Medical Center , Tel Aviv , Israel.|e Internal Medicine "E" Tel Aviv Sourasky Medical Center , Tel Aviv , Israel.
Shani
S
Shenhar-Tsarfaty
f The Immunology Laboratory at Clalit Health Services , Tel-Aviv , Israel.
Ronit
R
Weinberger
e Internal Medicine "E" Tel Aviv Sourasky Medical Center , Tel Aviv , Israel.
Ram
R
Gelman
g The Department of Epidemiology and Preventive Medicine , School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University , Tel-Aviv , Israel.
Tomer
T
Ziv-Baran
b Sackler Faculty of Medicine , Tel Aviv University , Tel-Aviv , Israel.|h Internal Medicine "D" Tel Aviv Sourasky Medical Center , Tel Aviv , Israel.
David
D
Zeltser
b Sackler Faculty of Medicine , Tel Aviv University , Tel-Aviv , Israel.
Itzhak
I
Shapira
b Sackler Faculty of Medicine , Tel Aviv University , Tel-Aviv , Israel.|e Internal Medicine "E" Tel Aviv Sourasky Medical Center , Tel Aviv , Israel.
Sholomo
S
Berliner
b Sackler Faculty of Medicine , Tel Aviv University , Tel-Aviv , Israel.|d Internal Medicine "C" Tel Aviv Sourasky Medical Center , Tel Aviv , Israel.
Ori
O
Rogowski
D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000378:metabolism*; D018450:Disease Progression; D005260:Female; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications / Q000378:metabolism* / Q000401:mortality; D008297:Male; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000150:complications / Q000378:metabolism*; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D012189:Retrospective Studies; D013534:Survival
D002097:C-Reactive Protein
CLL; CRP; overall survival; prognostic factor; second malignancy