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

Background: Chronic lymphocytic leukemia (CLL) is characterized by a heterogeneous clinical course, ranging from stable to more aggressive disease. Herein, we determined the prognostic significance of serum C-reactive protein (CRP) levels in patients with CLL Methods: A retrospective cohort study reviewing the records of 107 consecutive treatment naive patients with CLL and a control group comprised of apparently healthy individuals attending for periodic health examinations. Results: The median CRP level of patients with CLL was 0.19 mg/dL (0-2.9). In univariate analysis, high-CRP levels (>= 0.4 mg/dL) were significantly associated with an increased risk of mortality (HR = 3.97, 95% CI 1.64-9.62, p = .002) and development of second solid cancers (HR = 4.54, 95% CI 1.57-13.11, p = .005), compared to low-CRP values (< 0.4 mg/dL). In multivariate analysis, high-CRP retained statistical significance for all-cause mortality (HR = 2.81, 95% CI 1.04-7.57, p = .04) and the development of second solid malignancies (HR = 4.54, 95% CI 1.57-13.11, p = .005). Moreover, when compared to an apparently healthy population, CLL patients with high CRP levels had more than an eightfold risk of cancer. Conclusions: Elevated baseline CRP levels are associated with shorter survival and development of second cancers in patients with CLL. We suggest that increased CRP in patients with CLL may justify a more rigorous search for second cancers.