C-reactive protein serum level is a valuable and simple prognostic marker in norm Hodgkin's lymphoma

Interleukin-6 plays a central role in normal B-cell maturation and in proli feration of some B-cell malignancies including multiple myeloma and some no n Hodgkin's lymphomas (NHL). Furthermore, this cytokine also plays a major role in acute phase response by mediating synthesis of acute phase proteins such as C-reactive protein (CRP). In order to evaluate the exact role of C RP serum level as a simple prognostic factor, we analyzed CRP and IL-6 seru m levels in 39 patients with NHL. Eleven patients had low grade NHL, 15 int ermediate grade NHL, and 13 high grade NHL. Thirty percent of the patients presented detectable IL-6 serum levels (mean +/- SD: 33.6 +/- 95.2 U/ml, ra nge: 0 to 500). Increased serum CRP levels were found in 42% of the patient s with a mean of 29.2 +/- 41.97 mg/l (range: 0 to 129). Thirty seven patients were studied for both markers. Three groups of patien ts were determined. One with low IL-6 and CRP serum levels (N=21), a second with high level of both markers (N=10), and the third with high serum CRP levels alone (N=5). Only one patient had high level of serum IL-6 with no d etectable CRP. The correlation of serum IL-6 and CRP levels with patient su rvival was investigated. Median survival in the group with low IL-6 level w as not reached. 67% of patients of this group were still alive at 32 months from diagnosis. The group of patients with detectable IL-6 had a median of survival of 12 months (p<0.025). The survival of patients with a CRP<10 mg /l was not reached. 75% of patients survive at 32 months from diagnosis, wh ereas the group with higher CRP level reached a median survival at 8.5 mont hs (p<0.009). As expected, on univariate analysis, there is a significant r elationship between CRP and IL-6 levels (p<0.00017), and CRP levels and B s ymptoms (p<0.001). Furthermore there is a significant relationship between CRP and LDH levels (p<0.042). These results indicated that CRP may be consi dered as a valuable and easy prognostic biomarker of NHL.