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. 2023 Feb;173(1-2):15-20.
doi: 10.1007/s10354-022-00981-8. Epub 2022 Nov 28.

Significance of C-reactive protein in patients with chronic myelomonocytic leukemia

Jian Liang-Fonseca  1 , Klaus Geissler  2   3
Affiliations

Significance of C-reactive protein in patients with chronic myelomonocytic leukemia

Jian Liang-Fonseca et al. Wien Med Wochenschr. 2023 Feb.

Abstract
in English, German

In a retrospective study, we analyzed the prevalence of elevated C‑reactive protein (CRP) serum levels in 148 patients with chronic myelomonocytic leukemia (CMML), their potential prognostic impact, and potential correlations with laboratory features. Normal, up to 10-fold, and more than 10-fold elevated CRP levels were found in 18%, 59%, and 23% of CMML patients, respectively. Using the CRP cutoff value of 10 mg/L of the widely used Glasgow score, high CRP values were associated with inferior survival (13 vs. 39 months, p = 0.014), which retained prognostic significance in multivariate analysis. High CRP values were associated with lower hemoglobin levels. The survival difference between patients with normal (< 5 mg/L) and elevated CRP levels persisted after exclusion of patients with clinical infection. These findings indicate that in CMML patients, the presence of an acute-phase reaction is associated with a poor outcome, independent of clinical infection.

In einer retrospektiven Studie untersuchten die Autoren die Prävalenz erhöhter Werte für C‑reaktives Protein (CRP) bei 148 Patienten mit chronischer myelomonozytärer Leukämie (CMML), ihren potenziellen prognostischen Einfluss und ihre potenzielle Korrelation mit laborchemischen Parametern. Normale, bis 10-fach erhöhte und mehr als 10-fach erhöhte CRP-Werte waren bei 18 %, 59 % bzw. 23 % der CMML-Patienten zu finden. Bei dem CRP-Ccut-off-Wert von 10 mg/l des häufig verwendeten Glasgow Scores waren höhere CRP-Werte mit einem kürzeren Überleben assoziiert (13 vs. 39 Monate, p = 0,014), die ihre Signifikanz in der multivariaten Analyse behielten. Hohe CRP-Werte waren mit einem verminderten Hämoglobin vergesellschaftet. Der Überlebensunterschied zwischen Patienten mit normalem und erhöhtem CRP persistierte nach Ausschluss von Patienten mit Symptomen einer Infektion. Diese Ergebnisse zeigen, dass bei CMML-Patienten das Vorliegen einer Akute-Phase-Reaktion mit einem verschlechterten Outcome verbunden ist, unabhängig vom Vorliegen einer klinischen Infektion.

Keywords: Acute-phase reaction; CMML; C‑reactive protein; Glasgow score; Survival.

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Conflict of interest statement

J. Liang-Fonseca and K. Geissler declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Kaplan–Meier plots for overall survival in chronic myelomonocytic leukemia patients with and without C‑reactive protein (CRP) values ≥ 10 mg/L
See this image and copyright information in PMC

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