Evaluation of C-reactive protein and its prognostic relationship in patients with Hodgkin's Lymphoma.

Elizete Aparecida da Silva Negreiros, Talita Máira Bueno da Silveira, Sérgio Costa Fortier, Carlos Sérgio Chiattone
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Abstract

Objectives: To assess the prognostic value of C-Reactive Protein (CRP), at diagnosis and during follow-up, of patients with Hodgkin´s Lymphoma treated at the Hematology Service of the Santa Casa de São Paulo Hospital, and to correlate serum CRP levels with disease stage and treatment response.

Methods: A retrospective study involving review of 71 medical records of patients diagnosed with Hodgkin´s Lymphoma between February 2012 and January 2016 was performed. Three patients were subsequently excluded, giving a total of 68 patients for analysis. A level of CRP > 1mg/dl was considered elevated.

Results: Patients were predominantly male (61.8%) and mean age was 34 years. Fifty-three (78%) patients had advanced stage and (76.5%) had B symptoms. Elevated baseline CRP was associated with greater likelihood of B symptoms (p= 0.02) and of advanced stage (p= 0.015). Patients with Low CRP level after 5th and 6th cycles of chemotherapy was associated with complete response (p=0.04 and p=0.03, respectively). Treatment-refractory patients had greater risk of death (p=0.002).

Conclusion: CRP is clinically important for follow-up of patients with Hodgkin´s Lymphoma, where high levels were associated with advanced disease and/or presence of B symptoms. CRP level was considered a predictor of treatment response. Persistence of high CRP values during treatment was associated with refractoriness.

评估霍奇金淋巴瘤患者的 C 反应蛋白及其与预后的关系。
目的评估在圣保罗圣卡萨医院血液科接受治疗的霍奇金淋巴瘤患者在诊断时和随访期间C反应蛋白(CRP)的预后价值,并将血清CRP水平与疾病分期和治疗反应相关联:该研究回顾了2012年2月至2016年1月期间诊断为霍奇金淋巴瘤患者的71份病历。随后排除了3名患者,共有68名患者接受了分析。CRP水平大于1毫克/分升即为升高:患者主要为男性(61.8%),平均年龄为 34 岁。53名患者(78%)为晚期,76.5%的患者有B型症状。基线 CRP 升高与出现 B 型症状(p= 0.02)和晚期(p= 0.015)的可能性增加有关。第 5 和第 6 个化疗周期后 CRP 水平较低的患者与完全缓解相关(分别为 p=0.04 和 p=0.03)。治疗难治患者的死亡风险更高(P=0.002):CRP对霍奇金淋巴瘤患者的随访具有重要的临床意义,CRP水平高与疾病晚期和/或出现B症状有关。CRP水平被认为是治疗反应的预测因子。治疗期间 CRP 值持续偏高与难治性有关。
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