Prognostic value of Elevated Serum Inflammatory Markers in Adult Patients receiving Induction Chemotherapy for Acute Leukemia

Abdelmoneem, Shimaa; Al-Akkad, Mohammad; Fathy, Ayman; Yousef, Mohamed Gamal; Omran, Alaa A.; Metwally, Elsayed Anany

doi:10.21608/ejhm.2022.255157

Prognostic value of Elevated Serum Inflammatory Markers in Adult Patients receiving Induction Chemotherapy for Acute Leukemia

Document Type : Original Article

Authors

Internal medicine department, faculty of medicine, Zagazig university, Zagazig, Egypt

10.21608/ejhm.2022.255157

Abstract

Background: Leukemias are a diverse collection of neoplastic illnesses with distinct morphological, immunophenotypic, cytogenetic, and molecular characteristics of malignant cells. C-reactive protein (CRP) testing is traditionally used to assess the degree of infection, diagnosis of sepsis as well as the response to antimicrobial treatment. In the absence of iron overload, cancer patients have a higher level of serum ferritin. CRP and serum ferritin (SF) are inflammatory indicators that can predict the presence of systemic illness.
Objective: Our study aimed to estimate the role of serum ferritin and CRP in the early detection of systemic infection and the prognostic value of these markers in denovo adult patients receiving chemotherapy for acute leukemia.
Methods: This cross-sectional study was performed in the period from February 2016 to February 2017 in the Clinical Hematology Unit, Internal Medicine Department, and included 30 denovo adult patients who were diagnosed with acute leukemia; 14 of them were females and 16 were males.
Results: After a median follow-up period of 1 year with a range (1.1- 11.2) months; there was a statistically significant cumulative overall survival in younger, non-hyperferritinemia, non-septic patients, and in whom responded to therapy (p=0.02, 0.02 and 0.03 respectively). Furthermore, there was no statistically significant correlation of OS with CRP or erythrocyte sedimentation rate (ESR). Hyperferritinemia (>150) and elevated CRP (>33) were independable risk factors predicting sepsis (P=0.007 and 0.016 respectively) by using a Multivariate logistic regression model.
Conclusion: Modest elevation of the blood level of CRP and ferritin above the normal range showed an association with the probability of systemic infection in patients who underwent dose-intensive induction chemotherapy even in absence of clinical evidence of sepsis.

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