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

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.