Yair Herishanu1,2, Aaron Polliack3, Shani Shenhar-Tsarfaty4,5, Ronit Weinberger6, Ram Gelman5, Tomer Ziv-Baran7, David Zeltser2,8, Itzhak Shapira2, Sholomo Berliner2,5, Ori Rogowski2,4. 1. a The Department of Hematology , Tel Aviv Sourasky Medical Center , Tel Aviv , Israel. 2. b Sackler Faculty of Medicine , Tel Aviv University , Tel-Aviv , Israel. 3. c Hebrew University Medical School , Jerusalem , Israel. 4. d Internal Medicine "C" Tel Aviv Sourasky Medical Center , Tel Aviv , Israel. 5. e Internal Medicine "E" Tel Aviv Sourasky Medical Center , Tel Aviv , Israel. 6. f The Immunology Laboratory at Clalit Health Services , Tel-Aviv , Israel. 7. g The Department of Epidemiology and Preventive Medicine , School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University , Tel-Aviv , Israel. 8. h Internal Medicine "D" Tel Aviv Sourasky Medical Center , Tel Aviv , Israel.
Abstract
BACKGROUND: 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. RESULTS: 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. CONCLUSIONS: 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.
BACKGROUND: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. RESULTS: 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, CLLpatients with high CRP levels had more than an eightfold risk of cancer. CONCLUSIONS: 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.
Entities:
Keywords:
CLL; CRP; overall survival; prognostic factor; second malignancy
Authors: Uri Rozovski; Ivo Veletic; David M Harris; Ping Li; Zhiming Liu; Preetesh Jain; Taghi Manshouri; Alessandra Ferrajoli; Jan A Burger; Prithviraj Bose; Phillip A Thompson; Nitin Jain; William G Wierda; Srdan Verstovsek; Michael J Keating; Zeev Estrov Journal: J Immunol Date: 2022-05-20 Impact factor: 5.426
Authors: Neval E Wareham; Qiuju Li; Henrik Sengeløv; Caspar Da Cunha-Bang; Finn Gustafsson; Carsten Heilmann; Michael Perch; Allan Rasmussen; Søren Schwartz Sørensen; Amanda Mocroft; Jens D Lundgren Journal: J Cancer Res Clin Oncol Date: 2019-11-05 Impact factor: 4.553