Atlas of Hematology

C-Reactive Protein in the Follow-up and Estimation of Infections in Acute Leukemic Patients
Fifty-five febrile neutropenic episodes were monitored by C-reactive protein (CRP) in 26 patients with acute leukemia. In nonfebrile period of patients, serum CRP level was 0.89 mg/dL (range 0.1-8.8 mg/dL) while it was found to be raised to 9.57 mg/dL (range 0.5-24.1 mg/dL) in the febrile group (p= 0.0001). Serum CRP level at the onset of fever was 9.25 mg/dL (range 0.1-16.2 mg/dL) in patients in whom fever was treated succesfully with antipseudomonal beta-lactam antibiotic and aminoglycoside therapy declined to normal levels (p= 0.01); 17.0 mg/dL (range 5.2-33.5 mg/dL) in patients still persisting fever with this combined therapy and so obtained vancomycin (p= 0.001); 16.6 mg/dL (range 0-38.7 mg/dL) in patients required amphotericin B in addition (p= 0.001). In the initial febrile episode; fever resolved at day 3.3 ± 1.21 in patients with serum CRP value below 5 mg/dL; at day 4.42 ± 1.88 in patients with serum CRP value between 10-15 mg/dL; at day 5.14 ± 1.68 in patients with serum CRP value above 15 mg/dL. There was no statistical difference at the time of fever resolution among the first three groups. There was a remarkable difference between groups with CRP values below 5 mg/dL and above 15 mg/dL (p= 0.04). We conclude that determination of serum CRP level before and after infection in febrile neutropenic patients is useful for the follow-up and estimation of febrile neutropenic episode in acute leukemic patients.

Authors: Vahap Aslan, O. Meltem Akay, Zafer Gülbaş

Keywords: C-reaktif protein, Akut lösemi, Y, nfeksiyon. Turk J Haematol

Year: 2003
Number: 2
Referance No: 94399

Figure 1. Values of serum CRP in patients with fever resolution under antipseudomonal beta-lactam antibiotic and aminoglycoside therapy (n= 35).
Figure 2. Values of serum CRP in patients with fever resolution under antipseudomonal beta-lactam antibiotic + aminoglycoside + vancomycin therapy (n= 11).
Figure 3. Values of serum CRP in patients with fever under amphotericin B therapy (n= 23).

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