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.

Abstract	We monitored levels of C-reactive protein (CRP) in 96 consecutive adult allogeneic BMT patients (age 15-50 years) transplanted in our unit. Major transplant-related complications (MTC) occurred in 32% of cases and included: hepatic veno-occlusive disease, pneumonitis, severe endothelial leakage syndrome and >II acute GVHD. Transplant-related mortality (TRM) before day 100 post-BMT was 13.5%. Variables included in a stepwise logistic regression model were: gender, age, disease category, donor type, T cell depletion, TBI, use of growth factors, bacteremia, mean CRP-levels >50 mg/l between days 0 and 5 (CRP day 0-5) and >100 mg/l between days 6 and 10 (CRP day 6-10) post-BMT. Only high CRP-levels (for MTC and TRM) (P < 0.001) and donor-type (for TRM) (P= 0.02) were independent risk factors. The estimated probability for MTC was 73% (CRP day 6-10 >100 mg/l) vs 17% (CRP day 6-10 <100 mg/l). Using the same cut-off levels, the probabilities for TRM were 36.5% vs 1% in the identical sibling donor situation and 88% vs 12.5% in other donor-type transplants. We conclude that the degree of systemic inflammation, as reflected by CRP-levels, during the first 5-10 days after BMT identifies patients at risk of MTC and TRM. Our data may be useful in selecting patients for clinical trials involving pre-emptive anti-inflammatory treatment.
Authors	R Schots, I Van Riet, T Ben Othman, F Trullemans, M De Waele, B Van Camp, L Kaufman
Journal	Bone marrow transplantation (Bone Marrow Transplant) Vol. 30 Issue 7 Pg. 441-6 (Oct 2002) ISSN: 0268-3369 [Print] England
PMID	12368956 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References	Biomarkers C-Reactive Protein
Topics	Adolescent Adult Biomarkers (blood) Bone Marrow Transplantation (adverse effects, mortality) C-Reactive Protein (metabolism) Female Hematologic Diseases (complications, mortality, therapy) Humans Incidence Inflammation Male Middle Aged Retrospective Studies Risk Factors Transplantation, Homologous

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