Increased serum C-reactive protein levels are associated with shorter survival and development of second cancers in chronic lymphocytic leukemia

Figures & data

Table 1. Patient characteristics.

Parameter	Patients (n = 107)
Age (years), mean ± SD	71.5 ± 10.8
Male gender, no (%)	56 (52.5)
ALC (×10^9/μL), median (range)	10.4 (5.1–200)
Binet stage, no. (%)
I	93 (86.9)
II	6 (5.6)
III	8 (7.5)
CRP levels (mg/dL), median (range)	0.19 (0–2.9)
CRP ≥0.4 mg/dL, no. (%)	25(23.4)
Treatment, no. (%)	20 (18.7)
Death, no. (%)	20 (18.7)

Figure 1. (A) Kaplan–Meier curves of OS, (B) Cumulative incidence risk of developing solid malignancies, and (C) Kaplan–Meier curves of time to anti-leukemic treatment; subgrouped according to baseline CRP levels of <0.4 mg/dL and ≥0.4 mg/dL.

Figure 2. The cumulative incidence risk of developing non-hematological cancers in patients with CLL and apparently healthy individuals, stratified by serum CRP levels (<0.4 mg/dL and ≥0.4 mg/dL).

Table 2. Univariate and multivariate analyses of OS, second cancers, and treatment in patients with CLL.

	OS univariate analysis		OS multivariate analysis		Second cancer univariate analysis		Second cancer multivariate analysis		Treatment univariate analysis		Treatment multivariate analysis
Parameter	HR (95%CI)	p Value	HR (95%CI)	p Value	HR (95%CI)	p Value	HR (95%CI)	p Value	HR (95%CI)	p Value	HR (95%CI)	p Value
Age	1.10 (1.04–1.16)	.001	1.11 (1.04–1.17)	.001	1.02 (0.96–1.08)	.504			1.02 (0.97–1.06)	.401
Gender
Females	1 (ref.)				1 (ref.)				1(ref.)
Males	1.30 (0.54–3.14)	.564			1.30 (0.39–3.24)	.821			1.36 (0.57–3.23)	.489
ALC
<15x10^9/μL	1 (ref.)		1 (ref.)		1 (ref.)						1 (ref.)
≥15x10^9/μL	4.04 (1.55–10.55)	.004	2.95 (1.01–8.68)	.049	2.80 (0.97–8.08)	.06			3.60 (1.47–8.61)	.005	2.75 (1.11–6.81)	.028
Binet stage
I	1 (ref.)		1 (ref.)		1(ref.)				1 (ref.)		1 (ref.)
II–III	3.46 (1.32–9.06)	.012	3.54 (1.30–10.22)	.019	0.04 (0.0–78.1)	.407			6.73 (2.74–16.55)	<.001	5.33 (2.11–13.43)	<.001
Serum CRP
<0.4 mg/dL	1 (ref.)		1 (ref.)		1(ref.)		1 (ref.)		1(ref.)
≥0.4 mg/dL	3.97 (1.64–9.62)	.002	2.81 (1.04–7.57)	.041	4.54 (1.57–13.11)	.005	4.54 (1.57–13.11)	0.005	2.32 (0.97–5.53)	.059

Table 3. Multivariate Cox regression analysis, time to second cancer diagnosis.

Parameter	Hazard ratio	95%CI	p Value
Control CRP <0.4 mg/dL	1 (ref.)
Control CRP ≥0.4 mg/dL	1.27	1.01–1.61	.04
CLL CRP <0.4 mg/dL	1.55	0.66–3.60	.31
CLL CRP ≥0.4 mg/dL	8.62	4.62–17.46	<.001
Age	1.07	1.06–1.08	<.001