Herishanu Yair, Polliack Aaron, Shenhar-Tsarfaty Shani, Weinberger Ronit, Gelman Ram, Ziv-Baran Tomer, Zeltser David, Shapira Itzhak, Berliner Sholomo, Rogowski Ori
a The Department of Hematology , Tel Aviv Sourasky Medical Center , Tel Aviv , Israel.
b Sackler Faculty of Medicine , Tel Aviv University , Tel-Aviv , Israel.
Ann Med. 2017 Feb;49(1):75-82. doi: 10.1080/07853890.2016.1232860. Epub 2016 Nov 3.
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.
慢性淋巴细胞白血病（CLL）的临床病程具有异质性，从病情稳定到更为侵袭性的疾病不等。在此，我们确定了血清C反应蛋白（CRP）水平在CLL患者中的预后意义。方法：一项回顾性队列研究，回顾了107例连续的初治CLL患者的记录，并与一组定期进行健康检查的看似健康的个体组成的对照组进行比较。
CLL患者的CRP中位数水平为0.19mg/dL（0 - 2.9）。在单因素分析中，与低CRP值（<0.4mg/dL）相比，高CRP水平（≥0.4mg/dL）与死亡风险增加（HR = 3.97，95%CI 1.64 - 9.62，p = 0.002）和发生第二种实体癌的风险增加（HR = 4.54，95%CI 1.57 - 13.11，p = 0.005）显著相关。在多因素分析中，高CRP水平对全因死亡率（HR = 2.81，95%CI 1.04 - 7.57，p = 0.04）和第二种实体恶性肿瘤的发生（HR = 4.54，95%CI 1.57 - 13.11，p = 0.005）仍具有统计学意义。此外，与看似健康的人群相比，CRP水平高的CLL患者患癌风险高出八倍以上。
基线CRP水平升高与CLL患者的生存期缩短和第二种癌症的发生有关。我们认为，CLL患者CRP升高可能有必要更严格地筛查第二种癌症。关键信息：CRP水平升高与CLL患者的总生存期缩短有关。CRP水平升高与CLL患者发生第二种癌症的风险增加有关。CLL患者CRP升高可能有必要更严格地筛查第二种癌症。
