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C-Reactive Protein Monitoring Predicts Neutropenic Fever Following Autologous Hematopoietic Stem Cell Transplantation for Multiple Myeloma
Journal article   Open access   Peer reviewed

C-Reactive Protein Monitoring Predicts Neutropenic Fever Following Autologous Hematopoietic Stem Cell Transplantation for Multiple Myeloma

Vidya Kollu, Sarah L Mott, Rafiullah Khan, Umar Farooq, Yogesh Jethava, Ince Dilek and Guido Tricot
Curēus (Palo Alto, CA), Vol.10(7), pp.e2945-e2945
07/08/2018
DOI: 10.7759/cureus.2945
PMCID: PMC6128584
PMID: 30202676
url
https://doi.org/10.7759/cureus.2945View
Published (Version of record) Open Access

Abstract

Background Neutropenic fever (NF) is a known and common complication of autologous hematopoietic stem cell transplantation (ASCT). Early risk assessment may help direct treatment. We retrospectively analyzed the role of serial serum C-reactive protein (CRP) levels in predicting NF and assessed the clinical value of CRP within 14 days after transplantation. Methods One hundred twenty-one multiple myeloma (MM) patients received 170 first and/or second ASCT between January 2014 and March 2017. A Cox regression model was applied to assess the prognostic value of CRP as a time-dependent covariate at the onset of NF within 14 days post-transplant. Results Forty-seven of 170 patients developed NF. High CRP levels (4.0–43.2 mg/dL) were associated with a 5.45-fold increased risk of NF (P = 0.02). Patients had a nearly three-fold increased risk of NF after the second transplant (P < 0.01), but this was not associated with increased mortality. Those with NF had higher maximum values of CRP (P < 0.01) which tended to occur at or after the onset of NF. Conclusion CRP monitoring provides important information about the risk for NF immediately after first MM ASCT, and even more so after the second.
Oncology adult c-reactive protein febrile neutropenia hematopoietic stem cell transplantation Infectious Disease multiple myeloma Transplantation

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