Longitudinal trajectory patterns of plasma albumin and C-reactive protein levels around diagnosis, relapse, bacteraemia, and death of acute myeloid leukaemia patients

Kim Oren Gradel, Pedro Póvoa, Olav Sivertsen Garvik, Pernille Just Vinholt, Stig Lønberg Nielsen, Thøger Gorm Jensen, Ming Chen, Ram Benny Dessau, Jens Kjølseth Møller, John Eugenio Coia, Pernille Sanberg Ljungdalh, Annmarie Touborg Lassen, Henrik Frederiksen

Research output: Contribution to journalArticle

Abstract

BACKGROUND: No study has evaluated C-reactive protein (CRP) and plasma albumin (PA) levels longitudinally in patients with acute myeloid leukaemia (AML). METHODS: We studied defined events in 818 adult patients with AML in relation to 60,209 CRP and PA measures. We investigated correlations between CRP and PA levels and daily CRP and PA levels in relation to AML diagnosis, AML relapse, or bacteraemia (all ±30 days), and death (─30-0 days). RESULTS: On the AML diagnosis date (D0), CRP levels increased with higher WHO performance score (PS), e.g. patients with PS 3/4 had 68.1 mg/L higher CRP compared to patients with PS 0, adjusted for relevant covariates. On D0, the PA level declined with increasing PS, e.g. PS 3/4 had 7.54 g/L lower adjusted PA compared to PS 0. CRP and PA levels were inversely correlated for the PA interval 25-55 g/L (R = - 0.51, p < 10-5), but not for ≤24 g/L (R = 0.01, p = 0.57). CRP increases and PA decreases were seen prior to bacteraemia and death, whereas no changes occurred up to AML diagnosis or relapse. CRP increases and PA decreases were also found frequently in individuals, unrelated to a pre-specified event. CONCLUSIONS: PA decrease is an important biomarker for imminent bacteraemia in adult patients with AML.

Original languageEnglish
Article number249
Number of pages1
JournalBMC Cancer
Volume20
Issue number1
DOIs
Publication statusPublished - 24 Mar 2020

Keywords

  • Acute myeloid leukaemia
  • C-reactive protein
  • Infection
  • Inflammation
  • Plasma albumin

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