Abstract
BackgroundNo study has evaluated C-reactive protein (CRP) and plasma albumin (PA) levels longitudinally in patients with acute myeloid leukaemia (AML).MethodsWe studied defined events in 818 adult patients with AML in relation to 60,209 CRP and PA measures. We investigated correlations between CRP and PA levels and daily CRP and PA levels in relation to AML diagnosis, AML relapse, or bacteraemia (all ±30 days), and death (─30–0 days).ResultsOn the AML diagnosis date (D0), CRP levels increased with higher WHO performance score (PS), e.g. patients with PS 3/4 had 68.1 mg/L higher CRP compared to patients with PS 0, adjusted for relevant covariates. On D0, the PA level declined with increasing PS, e.g. PS 3/4 had 7.54 g/L lower adjusted PA compared to PS 0. CRP and PA levels were inversely correlated for the PA interval 25–55 g/L (R = − 0.51, p < 10–5), but not for ≤24 g/L (R = 0.01, p = 0.57). CRP increases and PA decreases were seen prior to bacteraemia and death, whereas no changes occurred up to AML diagnosis or relapse. CRP increases and PA decreases were also found frequently in individuals, unrelated to a pre-specified event.ConclusionsPA decrease is an important biomarker for imminent bacteraemia in adult patients with AML.
Highlights
No study has evaluated C-reactive protein (CRP) and plasma albumin (PA) levels longitudinally in patients with acute myeloid leukaemia (AML)
A total of 818 patients were diagnosed with AML between January 2000 and May 2017
Treatment data (Table 1) enabled the Discussion We found high inverse correlations between CRP and PA levels in 818 adult patients with AML
Summary
No study has evaluated C-reactive protein (CRP) and plasma albumin (PA) levels longitudinally in patients with acute myeloid leukaemia (AML). The close monitoring of acute myeloid leukaemia (AML) patients in routine care includes an array of Gradel et al BMC Cancer (2020) 20:249 events (e.g. AML diagnosis or treatment). Studies that assess biomarker levels and their changes over time (longitudinal studies) around well-defined events such as diagnosis, treatment, relapse, bacteraemia, or death may help elucidate this. We have only encountered few longitudinal studies on CRP levels, all with 63 patients or less [6,7,8,9,10]. No study has assessed the PA level as a biomarker of infectious episodes or other events in haematological cancer patients
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