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Published on: October 31, 2012
Early elevation of C-reactive protein correlates with severe infection and nonrelapse mortality in children
Jennifer L McNeer1, Morris Kletzel, Alfred Rademaker
1Department of Pediatrics, Section of Hematology/Oncology, University of Chicago, Chicago, Illinois, USA.
Insights
Early elevations in C-reactive protein (CRP) indicate higher risk for complications and mortality in pediatric hematopoietic stem cell transplantation (HSCT) patients. This finding may help identify at-risk children needing closer monitoring post-transplant.
Area of Science:
- Pediatric Hematology
- Immunology
- Transplantation Science
Background:
- C-reactive protein (CRP) is a key indicator of systemic inflammation.
- Elevated CRP is linked to adverse outcomes in adult hematopoietic stem cell transplantation (HSCT).
- The role of early CRP in pediatric HSCT complications requires further investigation.
Purpose of the Study:
- To assess the association between early CRP levels and complications in pediatric HSCT.
- To determine if CRP predicts nonrelapse mortality in pediatric HSCT recipients.
- To evaluate CRP as a predictive marker for treatment-related morbidity and mortality.
Main Methods:
- Seventy pediatric patients undergoing HSCT were included.
- CRP levels were measured during the first week post-transplant.
- Patients were monitored for 100 days for complications and mortality.
Main Results:
- Patients who developed severe infections had significantly higher median CRP levels (8.03 mg/dL vs. 1.64 mg/dL).
- Nonrelapse mortality was associated with higher median CRP values (12.6 mg/dL vs. 2.44 mg/dL).
- Early CRP elevations correlated with increased risk of complications and mortality.
Conclusions:
- Elevated early CRP levels are a potential marker for increased risk in pediatric HSCT.
- CRP monitoring may aid in identifying high-risk pediatric patients post-transplant.
- These findings support using CRP for risk stratification in pediatric HSCT.
Abstract:
C-reactive protein (CRP) is an acute phase reactant that is a reliable marker of systemic inflammation and has been associated with increased morbidity and mortality following hematopoietic stem cell transplantation (HSCT) in adults. In this study, we evaluated whether early elevations of CRP were associated with various complications and nonrelapse mortality following HSCT in pediatric patients. Seventy pediatric patients had CRP levels drawn at regular time points during the first week following their transplants. Patients were followed for 100 days following transplant, and transplant-related complications were documented. Patients who subsequently developed severe infections had higher median CRP values than those without severe infections (median 8.03 mg/dL versus 1.64 mg/dL, P = .0008) as did those who suffered nonrelapse mortality compared with those who did not (12.6 mg/dL versus 2.44 mg/dL, P = .02). These findings suggest that elevated CRP values may be useful as a marker of individual pediatric patients with a higher risk for treatment-related morbidity and mortality.
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