C- reactive protein in autologous stem cell transplantation: prediction of clinical complication

Authors

  • Bruna Sabioni Universidade Federal do Rio de Janeiro
  • Eduardo Edelman Saul Universidade Federal do Rio de Janeiro
  • Rodrigo Portugal Universidade Federal do Rio de Janeiro
  • Marcia Rejane Valentim Complexo Hospitalar de Niteroi
  • Angelo Maiolino Universidade Federal do Rio de Janeiro
  • Marcia Garnica Universidade Federal do Rio de Janeiro

DOI:

https://doi.org/10.46765/2675-374X.2021v2n2p44

Keywords:

autologous stem cell transplant; febrile neutropenia; complication; C-reactive protein; mucositis

Abstract

Objective: The aim of this study was to evaluate C-reactive protein (CRP) as a predictor of complications during autologous stem cell transplant (HSCT). Methods: We analyzed a cohort of 340 transplants. Correlation analyses were performed, including CRP obtained before HSCT, on Day+3, Day+6, Day+9, after Day+11, and at the onset of febrile neutropenia, and the following outcomes: bacteremia, severity of mucositis, length of neutropenia and hospitalization, and death. Results: the median age was 54 years old (ranging from 20 to 75), and 62% and 20% were multiple myeloma and non-Hodgkin lymphoma cases, respectively.  The median CRP levels increased from D+3 to D+9 and after that decreased progressively until discharge. CRP levels were associated with bacteremia, mucositis grade, length of neutropenia and hospitalization, and death. Variation in CRP values from D+3 to D+6 predicted complications. Mortality was associated with D+9 CRP levels (19 vs. 7.9 mg/dL; p<0.01), and a ROC curve area of 0.83 (95% CI 0.7 – 0.95) to predict mortality. At a cut-off of 8.5mg/dL, D+9 CRP had 83% and 79% sensitivity and specificity, respectively.

Conclusions: In this study, CRP dynamics were associated with several HSCT complications. CRP levels curve could be applied to indicate poor outcomes during HSCT.

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Published

07/14/2021

How to Cite

Sabioni, B., Saul, E. E., Portugal, R., Valentim, M. R., Maiolino, A., & Garnica, M. (2021). C- reactive protein in autologous stem cell transplantation: prediction of clinical complication. JOURNAL OF BONE MARROW TRANSPLANTATION AND CELLULAR THERAPY, 2(2), p44. https://doi.org/10.46765/2675-374X.2021v2n2p44