Survival and CRP Levels Prior to Transplantation in Patients With Multiple Myeloma
Elevated pretransplant C-reactive protein (CRP) levels seem to be associated with worse overall survival in patients with multiple myeloma who underwent autologous stem cell transplantation (ASCT), according to a retrospective study published in Bone Marrow Transplantation. This finding was especially evident in those who received ASCT more than 12 months after diagnosis. Thus, Rajshekhar Chakraborty, MD, of the Mayo Clinic in Rochester, Minnesota, and colleagues recommend incorporating an evaluation of pretransplant CRP levels for patients undergoing delayed ASCT.
The study analyzed 1111 patients with multiple myeloma who underwent ASCT at the Mayo Clinic between 2007 and 2015. Of them, 840 received ASCT within 12 months (early patients) of diagnosis, and 271 received ASCT more than 12 months from diagnosis (delayed patients). Elevated CRP levels (greater than the upper normal limit of 8 mg/dL) were seen in 14% and 22% of patients undergoing early and delayed ASCT, respectively.
Among the patients who underwent early ASCT, those with elevated CRP levels had significantly worse overall survival than did those with normal CRP levels (91 months vs not reached, respectively). In the delayed ASCT cohort, similar results were seen (30 months vs 73 months, respectively).