Biology of Blood and Marrow Transplantation
Volume 16, Issue 3 , Pages 350-357 , March 2010

Early Elevation of C-Reactive Protein Correlates with Severe Infection and Nonrelapse Mortality in Children Undergoing Allogeneic Stem Cell Transplantation

  • Jennifer L. McNeer

      Affiliations

    • University of Chicago, Department of Pediatrics, Section of Hematology/Oncology, Chicago, Illinois
  • ,
  • Morris Kletzel

      Affiliations

    • Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
    • Children's Memorial Hospital, Chicago, Illinois
  • ,
  • Alfred Rademaker

      Affiliations

    • Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
  • ,
  • Kavita Alford

      Affiliations

    • Children's Memorial Hospital, Chicago, Illinois
  • ,
  • Kathleen O'Day

      Affiliations

    • University Medical Center at Princeton, Princeton, New Jersey
  • ,
  • Colleen Schaefer

      Affiliations

    • Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
    • Children's Memorial Hospital, Chicago, Illinois
  • ,
  • Reggie Duerst

      Affiliations

    • Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
    • Children's Memorial Hospital, Chicago, Illinois
  • ,
  • David A. Jacobsohn

      Affiliations

    • Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
    • Children's Memorial Hospital, Chicago, Illinois
    • Corresponding Author InformationCorrespondence and reprint requests: David A. Jacobsohn, MD, Northwestern University School of Medicine, Stem Cell Transplant Program, Children's Memorial Hospital, 2300 Children's Plaza, Box #30, Chicago, IL 60614.

Received 16 September 2009 ,Accepted 20 October 2009.

References 

  1. Gratwohl A, Hermans J, Goldman JM, et al. Risk assessment for patients with chronic myeloid leukaemia before allogeneic blood or marrow transplantation. Chronic Leukemia Working Party of the European Group for Blood and Marrow Transplantation. Lancet. 1998;352:1087–1092
  2. Nash RA, Pepe MS, Storb R, et al. Acute graft-versus-host disease: analysis of risk factors after allogeneic marrow transplantation and prophylaxis with cyclosporine and methotrexate. Blood. 1992;80:1838–1845
  3. Rocha V, Cornish J, Sievers EL, et al. Comparison of outcomes of unrelated bone marrow and umbilical cord blood transplants in children with acute leukemia. Blood. 2001;97:2962–2971
  4. Eapen M, Zhang MJ, Devidas M, et al. Outcomes after HLA-matched sibling transplantation or chemotherapy in children with acute lymphoblastic leukemia in a second remission after an isolated central nervous system relapse: a collaborative study of the Children's Oncology Group and the Center for International Blood and Marrow Transplant Research. Leukemia. 2008;22:281–286
  5. Schlenk RF, Pasquini MC, Perez WS, et al. HLA-identical sibling allogeneic transplants versus chemotherapy in acute myelogenous leukemia with t(8;21) in first complete remission: collaborative study between the German AML Intergroup and CIBMTR. Biol Blood Marrow Transplant. 2008;14:187–196
  6. Shi-Xia X, Xian-Hua T, Xiang-Feng T. Unrelated umbilical cord blood transplantation and unrelated bone marrow transplantation in children with hematological disease: a meta-analysis. Pediatr Transplant. 2009;13:278–284
  7. Black S, Kushner I, Samols D. C-reactive Protein. J Biol Chem. 2004;279:48487–48490
  8. Gabay C, Kushner I. Acute-phase proteins and other systemic responses to inflammation. N Engl J Med. 1999;340:448–454
  9. Saarinen UM, Strandjord SE, Warkentin PI, Cheung NK, Lazarus HM, Coccia PF. Differentiation of presumed sepsis from acute graft-versus-host disease by C-reactive protein and serum total IgE in bone marrow transplant recipients. Transplantation. 1987;44:540–546
  10. Fuji S, Kim SW, Fukuda T, et al. Preengraftment serum C-reactive protein (CRP) value may predict acute graft-versus-host disease and nonrelapse mortality after allogeneic hematopoietic stem cell transplantation. Biol Blood Marrow Transplant. 2008;14:510–517
  11. Pihusch M, Pihusch R, Fraunberger P, et al. Evaluation of C-reactive protein, interleukin-6, and procalcitonin levels in allogeneic hematopoietic stem cell recipients. Eur J Haematol. 2006;76:93–101
  12. Schots R, Kaufman L, Van Riet I, et al. Monitoring of C-reactive protein after allogeneic bone marrow transplantation identifies patients at risk of severe transplant-related complications and mortality. Bone Marrow Transplant. 1998;22:79–85
  13. Schots R, Van Riet I, Othman TB, et al. An early increase in serum levels of C-reactive protein is an independent risk factor for the occurrence of major complications and 100-day transplant-related mortality after allogeneic bone marrow transplantation. Bone Marrow Transplant. 2002;30:441–446
  14. Artz AS, Wickrema A, Dinner S, et al. Pretreatment C-reactive protein is a predictor for outcomes after reduced-intensity allogeneic hematopoietic cell transplantation. Biol Blood Marrow Transplant. 2008;14:1209–1216
  15. Sauer M, Tiede K, Fuchs D, Gruhn B, Berger D, Zintl F. Procalcitonin, C-reactive protein, and endotoxin after bone marrow transplantation: identification of children at high risk of morbidity and mortality from sepsis. Bone Marrow Transplant. 2003;31:1137–1142
  16. Gonzalez-Vicent M, Marin C, Madero L, Sevilla J, Diaz MA. Risk score for pediatric intensive care unit admission in children undergoing hematopoietic stem cell transplantation and analysis of predictive factors for survival. J Pediatr Hematol Oncol. 2005;27:526–531
  17. Schneider DT, Lemburg P, Sprock I, Heying R, Gobel U, Nurnberger W. Introduction of the oncological pediatric risk of mortality score (O-PRISM) for ICU support following stem cell transplantation in children. Bone Marrow Transplant. 2000;25:1079–1086
  18. Tse WT, Duerst R, Schneiderman J, Chaudhury S, Jacobsohn D, Kletzel M. Age-dependent pharmacokinetic profile of single daily dose i.v. busulfan in children undergoing reduced-intensity conditioning stem cell transplant. Bone Marrow Transplant. 2009;44:145–156
  19. Schneiderman J, Duerst R, Tse W, Thormann K, Kletzel M, Jacobsohn DA. Reduced intensity conditioning (RIC) and hematopoietic stem cell transplantation (HSCT) using photopheresis (ECP), fludarabine, and targeted single dose busulfan as an outpatient procedure in children: preliminary results. Biol Blood Marrow Transplant. 2007;13(Suppl 2):
  20. Jacobsohn DA, Hewlett B, Ranalli M, Seshadri R, Duerst R, Kletzel M. Outcomes of unrelated cord blood transplants and allogeneic-related hematopoietic stem cell transplants in children with high-risk acute lymphocytic leukemia. Bone Marrow Transplant. 2004;34:901–907
  21. Przepiorka D, Weisdorf D, Martin P, et al. 1994 Consensus conference on acute GVHD grading. Bone Marrow Transplant. 1995;15:825–828
  22. Wang LJ, Chou P, Gonzalez-Ryan L, Huang W, Haut PR, Kletzel M. Evaluation of mixed hematopoietic chimerism in pediatric patients with leukemia after allogeneic stem cell transplantation by quantitative PCR analysis of variable number of tandem repeat and testis determination gene. Bone Marrow Transplant. 2002;29:51–56
  23. Prat C, Sancho JM, Dominguez J, et al. Evaluation of procalcitonin, neopterin, C-reactive protein, IL-6 and IL-8 as a diagnostic marker of infection in patients with febrile neutropenia. Leuk Lymphoma. 2008;49:1752–1761
  24. El-Maghraby SM, Moneer MM, Ismail MM, Shalaby LM, El-Mahallawy HA. The diagnostic value of C-reactive protein, interleukin-8, and monocyte chemotactic protein in risk stratification of febrile neutropenic children with hematologic malignancies. J Pediatr Hematol Oncol. 2007;29:131–136
  25. Kitko CL, Paczesny S, Yanik G, et al. Plasma elevations of tumor necrosis factor-receptor-1 at day 7 postallogeneic transplant correlate with graft-versus-host disease severity and overall survival in pediatric patients. Biol Blood Marrow Transplant. 2008;14:759–765
  26. Paczesny S, Krijanovski OI, Braun TM, et al. A biomarker panel for acute graft-versus-host disease. Blood. 2009;113:273–278
  27. Pulliam PN, Attia MW, Cronan KM. C-reactive protein in febrile children 1 to 36 months of age with clinically undetectable serious bacterial infection. Pediatrics. 2001;108:1275–1279
  28. Peltola H, Jaakkola M. C-reactive protein in early detection of bacteremic versus viral infections in immunocompetent and compromised children. J Pediatr. 1988;113:641–646
  29. Shaoul R, Lahad A, Tamir A, Lanir A, Srugo I. C reactive protein (CRP) as a predictor for true bacteremia in children. Med Sci Monit. 2008;14:CR255–CR261
  30. Nimmerjahn F, Ravetch JV. Anti-inflammatory actions of intravenous immunoglobulin. Annu Rev Immunol. 2008;26:513–533
  31. Choi SW, Kitko CL, Braun T, et al. Change in plasma tumor necrosis factor receptor 1 levels in the first week after myeloablative allogeneic transplantation correlates with severity and incidence of GVHD and survival. Blood. 2008;112:1539–1542

 Financial disclosure: See Acknowledgments on page 356.

PII: S1083-8791(09)00589-8

doi: 10.1016/j.bbmt.2009.10.036

Biology of Blood and Marrow Transplantation
Volume 16, Issue 3 , Pages 350-357 , March 2010