Evaluation of C-reactive protein and its prognostic relationship in patients with Hodgkin's Lymphoma

Objectives:  To assess the prognostic value of C-Reactive Protein (CRP), at diagnosis and during follow-up, of patients with Hodgkin's Lymphoma treated at the Hematology Service of the Santa Casa de Saão Paulo Hospital, and to correlate serum CRP levels with disease stage and treatment response.

Methods:  A retrospective study involving review of 71 medical records of patients diagnosed with Hodgkin's Lymphoma between February 2012 and January 2016 was performed. Three patients were subsequently excluded, giving a total of 68 patients for analysis. A level of CRP > 1 mg/dl was considered elevated.

Results:  Patients were predominantly male (61.8 %) and mean age was 34 years. Fifty-three (78 %) patients had advanced stage and (76.5 %) had B symptoms. Elevated baseline CRP was associated with greater likelihood of B symptoms (p = 0.02) and of advanced stage (p = 0.015). Patients with Low CRP level after 5th and 6th cycles of chemotherapy was associated with complete response (p = 0.04 and p = 0.03, respectively). Treatment-refractory patients had greater risk ofdeath (p = 0.002).

Conclusion:  CRP is clinically important for follow-up of patients with Hodgkin's Lymphoma, where high levels were associated with advanced disease and/or presence of B symptoms. CRP level was considered a predictor of treatment response. Persistence of high CRP values during treatment was associated with refractoriness.

Keywords:
Hodgkin's Lymphoma; C-reactive protein; Prognostic factors