Early detection of infectious complications during induction therapy for acute leukemia with serial C-reactive protein biomarker assessment

Shai Shimony, Uri Rozovski, Neta Sudry, Moshe Yeshurun, Dafna Yahav, Pia Raanani, Ofir Wolach*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Febrile neutropenia (FN) and blood stream infections (BSI) are major complications of induction treatment for acute leukemia. We assessed the predictive utility of C-reactive protein (CRP), an acute phase reactant, for FN and BSI during induction. CRP levels and dynamics were analyzed in 138 consecutive patients. FN and BSI occurred in 110 (80.3%) and 10 (7.5%) patients, respectively. Median peak CRP level in the 24-hours preceding FN was 7.5 mg/dl (0.2–38.1) vs. median peak CRP level of 5.11 mg/dl (0.2–23.1, p =.009) in patients without FN. CRP levels preceding BSI were 13.1 mg/dl (6.9–27.9) vs. 6.3 mg/dl (0.16–38.14, p =.011). CRP increase prior to event (ΔCRP) was higher among patients with BSI vs. patients without BSI (p =.013). CRP was predictive for FN (p =.009) and BSI (p =.01) on ROC curve analysis and was also independently associated with FN on multivariate analysis. In conclusion, CRP is a sensitive biomarker that precedes FN and BSI.

Original languageEnglish
Pages (from-to)2708-2713
Number of pages6
JournalLeukemia and Lymphoma
Volume61
Issue number11
DOIs
StatePublished - Nov 2020

Keywords

  • Acute leukemia
  • C-reactive protein
  • blood stream infection
  • febrile neutropenia
  • induction therapy

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