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Taş-Aygar G, Ataş H, Gönül M, Kartal SP. Importance of the C-Reactive Protein to Albumin Ratio in the Diagnosis and Prognosis of Mycosis Fungoides. Dermatol Pract Concept 2024; 14:dpc.1402a97. [PMID: 38810087 PMCID: PMC11135996 DOI: 10.5826/dpc.1402a97] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2023] [Indexed: 05/31/2024] Open
Abstract
INTRODUCTION The C-reactive protein to albumin ratio (CAR) lately has demonstrated as a prognostic factor and an indicator of disease activity, severity and prognosis in solid organ malignancies and inflammatory diseases. However, the effects of CAR have not been investigated in mycosis fungoides (MF) patients yet. OBJECTIVES This study aimed to determine the potential role of CAR as a diagnostic and a prognostic indicator in MF. METHODS We retrospectively investigated the electronic medical records of 97 patients with MF admitted to the Dermatology Clinic of Health Sciences University, Diskapi Yildirim Beyazit Training and Research Hospital between January 2014 and December 2020. In total, 60 patients with MF were enrolled in the study. CAR was evaluated, patient and control group. Also, the other clinicopathological factors including age, lactate dehydrogenase, stage of disease, beta-2-microglobulin levels, and sedimentation levels were evaluated. RESULTS The median value of CAR was 0.85 (0.10-7.51) in the patient group, whereas it was 0.39 (0.0-1.11) in the control group (P < 0.001). Patients with disease progression (N = 16, 13M, 3 F) had a median value of CAR 0.84 (0.10-7.51) and the median value of CAR (N = 44) was 0.86 (0.12-4.57) in the group of patients with stable disease. The CAR value had no prognostic significance (P > 0.05). CONCLUSIONS There is no association between the CAR and progression in the stage in MF patients. But the CAR is significantly higher in patients with MF than in the control group. The CAR can be a guide for us in cases where we have difficulty in diagnosing.
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Affiliation(s)
- Gamze Taş-Aygar
- University of Health Sciences, Etlik City Hospital, Dermatology Clinic, Ankara, Turkey
| | - Hatice Ataş
- University of Health Sciences, Etlik City Hospital, Dermatology Clinic, Ankara, Turkey
| | - Müzeyyen Gönül
- University of Health Sciences, Etlik City Hospital, Dermatology Clinic, Ankara, Turkey
| | - Selda Pelin Kartal
- University of Health Sciences, Etlik City Hospital, Dermatology Clinic, Ankara, Turkey
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Negreiros EADS, da Silveira TMB, Fortier SC, Chiattone CS. Evaluation of C-reactive protein and its prognostic relationship in patients with Hodgkin's Lymphoma. Hematol Transfus Cell Ther 2024:S2531-1379(24)00003-8. [PMID: 38307826 DOI: 10.1016/j.htct.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/17/2023] [Indexed: 02/04/2024] Open
Abstract
OBJECTIVES To assess the prognostic value of C-Reactive Protein (CRP), at diagnosis and during follow-up, of patients with Hodgkin´s Lymphoma treated at the Hematology Service of the Santa Casa de São Paulo Hospital, and to correlate serum CRP levels with disease stage and treatment response. METHODS A retrospective study involving review of 71 medical records of patients diagnosed with Hodgkin´s Lymphoma between February 2012 and January 2016 was performed. Three patients were subsequently excluded, giving a total of 68 patients for analysis. A level of CRP > 1mg/dl was considered elevated. RESULTS Patients were predominantly male (61.8%) and mean age was 34 years. Fifty-three (78%) patients had advanced stage and (76.5%) had B symptoms. Elevated baseline CRP was associated with greater likelihood of B symptoms (p= 0.02) and of advanced stage (p= 0.015). Patients with Low CRP level after 5th and 6th cycles of chemotherapy was associated with complete response (p=0.04 and p=0.03, respectively). Treatment-refractory patients had greater risk of death (p=0.002). CONCLUSION CRP is clinically important for follow-up of patients with Hodgkin´s Lymphoma, where high levels were associated with advanced disease and/or presence of B symptoms. CRP level was considered a predictor of treatment response. Persistence of high CRP values during treatment was associated with refractoriness.
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Affiliation(s)
| | - Talita Máira Bueno da Silveira
- Irmandade da Santa Casa de Misericórdia de São Paulo, Faculdade de Ciências Médicas da Santa Casa de São Paulo. São Paulo/SP, Brazil
| | - Sérgio Costa Fortier
- Irmandade da Santa Casa de Misericórdia de São Paulo, Faculdade de Ciências Médicas da Santa Casa de São Paulo. São Paulo/SP, Brazil
| | - Carlos Sérgio Chiattone
- Irmandade da Santa Casa de Misericórdia de São Paulo, Faculdade de Ciências Médicas da Santa Casa de São Paulo. São Paulo/SP, Brazil
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Negreiros E, Bueno da Silveira TM, Fortier SC, Chiattone CS. Evaluation of C-reactive protein and its prognostic relationship in patients with Hodgkin's Lymphoma. Hematol Transfus Cell Ther 2023:S2531-1379(23)02604-4. [PMID: 38233302 DOI: 10.1016/j.htct.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 07/19/2023] [Accepted: 11/17/2023] [Indexed: 01/19/2024] Open
Abstract
OBJECTIVES To assess the prognostic value of C-Reactive Protein (CRP), at diagnosis and during follow-up, of patients with Hodgkin´s Lymphoma treated at the Hematology Service of the Santa Casa de São Paulo Hospital, and to correlate serum CRP levels with disease stage and treatment response. METHODS A retrospective study involving review of 71 medical records of patients diagnosed with Hodgkin´s Lymphoma between February 2012 and January 2016 was performed. Three patients were subsequently excluded, giving a total of 68 patients for analysis. A level of CRP > 1 mg/dl was considered elevated. RESULTS Patients were predominantly male (61.8 %) and mean age was 34 years. Fifty-three (78 %) patients had advanced stage and (76.5 %) had B symptoms. Elevated baseline CRP was associated with greater likelihood of B symptoms (p = 0.02) and of advanced stage (p = 0.015). Patients with Low CRP level after 5th and 6th cycles of chemotherapy was associated with complete response (p = 0.04 and p = 0.03, respectively). Treatment-refractory patients had greater risk of death (p = 0.002). CONCLUSION CRP is clinically important for follow-up of patients with Hodgkin´s Lymphoma, where high levels were associated with advanced disease and/or presence of B symptoms. CRP level was considered a predictor of treatment response. Persistence of high CRP values during treatment was associated with refractoriness.
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Affiliation(s)
- Elizete Negreiros
- Irmandade da Santa Casa de Misericórdia de São Paulo, Faculdade de Ciências Médicas da Santa Casa de São Paulo. São Paulo SP, Brazil.
| | - Talita Máira Bueno da Silveira
- Irmandade da Santa Casa de Misericórdia de São Paulo, Faculdade de Ciências Médicas da Santa Casa de São Paulo. São Paulo SP, Brazil
| | - Sérgio Costa Fortier
- Irmandade da Santa Casa de Misericórdia de São Paulo, Faculdade de Ciências Médicas da Santa Casa de São Paulo. São Paulo SP, Brazil
| | - Carlos Sérgio Chiattone
- Irmandade da Santa Casa de Misericórdia de São Paulo, Faculdade de Ciências Médicas da Santa Casa de São Paulo. São Paulo SP, Brazil
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Keller FG, Castellino SM, Chen L, Pei Q, Voss SD, McCarten KM, Senn SL, Buxton AB, Bush R, Constine LS, Schwartz CL. Results of the AHOD0431 trial of response adapted therapy and a salvage strategy for limited stage, classical Hodgkin lymphoma: A report from the Children's Oncology Group. Cancer 2018; 124:3210-3219. [PMID: 29738613 DOI: 10.1002/cncr.31519] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 11/25/2017] [Accepted: 04/08/2018] [Indexed: 11/08/2022]
Abstract
BACKGROUND The Children's Oncology Group AHOD0431 study evaluated a response-directed treatment paradigm in which minimal initial chemotherapy and low-dose radiation was received only by patients who did not achieve a complete remission, and a chemotherapy/low-dose radiation salvage regimen was received by those who had a protocol-defined, low-risk recurrence. METHODS Patients younger than 21 years who had stage IA or IIA nonbulky disease were eligible. The treatment strategy was evaluated by determining the proportion that received minimal chemotherapy alone, the proportion that had a first or second remission without the receipt of high-dose chemotherapy/stem cell rescue or higher dose involved-field radiation therapy (>21 grays), and overall survival. RESULTS In total, 278 patients were eligible. At 4 years, 49.0% had received minimal chemotherapy and no radiation, 88.8% were in remission without receiving high-dose chemotherapy with stem cell rescue or >21 grays of involved-field radiation therapy, and the overall survival rate was 99.6%. Patients who had mixed cellularity histology had a 4-year event-free survival (EFS) rate of 95.2%, which was significantly better than the 75.8% EFS for those who had nodular sclerosis histology (P = .008). A red blood cell sedimentation rate ≤20 mm/hour and a negative fluorodeoxyglucose-positron emission tomography scan after 1 cycle of chemotherapy (PET1) were associated with a favorable EFS outcome. The study was closed early when the receipt of radiation therapy exceeded the predefined monitoring boundary. CONCLUSIONS This limited chemotherapy response-based approach was successful in patients who had a negative PET1 result, had MC histology, or had a low red blood cell sedimentation rate. In this treatment paradigm, evaluation of increased chemotherapy intensity or the integration of active new agents is indicated for patients who have nodular sclerosis histology with a high ESR or who have a positive PET1 result. Cancer 2018. © 2018 American Cancer Society.
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Affiliation(s)
- Frank G Keller
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta and Emory University, Atlanta, Georgia
| | - Sharon M Castellino
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta and Emory University, Atlanta, Georgia
| | - Lu Chen
- Department of Information Sciences, City of Hope, Duarte, California
| | - Qinglin Pei
- Statistics and Data Center, Children's Oncology Group, University of Florida, Gainesville, Florida
| | - Stephan D Voss
- Department of Radiology, Boston Children's Hospital, Dana-Farber/Harvard Cancer Center, Boston, Massachusetts
| | - Kathleen M McCarten
- Department of Diagnostic Imaging, Brown University Alpert Medical School, Providence, Rhode Island
| | - Stacy L Senn
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta and Emory University, Atlanta, Georgia
| | - Allen B Buxton
- Statistics and Data Center, Children's Oncology Group, University of Florida, Gainesville, Florida
| | - Rizvan Bush
- Statistics and Data Center, Children's Oncology Group, University of Florida, Gainesville, Florida
| | - Louis S Constine
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, New York
| | - Cindy L Schwartz
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
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Herishanu Y, Polliack A, Shenhar-Tsarfaty S, Weinberger R, Gelman R, Ziv-Baran T, Zeltser D, Shapira I, Berliner S, Rogowski O. Increased serum C-reactive protein levels are associated with shorter survival and development of second cancers in chronic lymphocytic leukemia. Ann Med 2017; 49:75-82. [PMID: 27595291 DOI: 10.1080/07853890.2016.1232860] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
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 naïve 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. KEY MESSAGES Elevated CRP levels are associated with a shorter overall survival in CLL. Elevated CRP levels are associated with an increased risk of second cancers in CLL. Increased CRP in patients with CLL may justify a more rigorous search for second cancers.
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Affiliation(s)
- Yair Herishanu
- a The Department of Hematology , Tel Aviv Sourasky Medical Center , Tel Aviv , Israel.,b Sackler Faculty of Medicine , Tel Aviv University , Tel-Aviv , Israel
| | | | - Shani Shenhar-Tsarfaty
- d Internal Medicine "C" Tel Aviv Sourasky Medical Center , Tel Aviv , Israel.,e Internal Medicine "E" Tel Aviv Sourasky Medical Center , Tel Aviv , Israel
| | - Ronit Weinberger
- f The Immunology Laboratory at Clalit Health Services , Tel-Aviv , Israel
| | - Ram Gelman
- e Internal Medicine "E" Tel Aviv Sourasky Medical Center , Tel Aviv , Israel
| | - Tomer Ziv-Baran
- g The Department of Epidemiology and Preventive Medicine , School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University , Tel-Aviv , Israel
| | - David Zeltser
- b Sackler Faculty of Medicine , Tel Aviv University , Tel-Aviv , Israel.,h Internal Medicine "D" Tel Aviv Sourasky Medical Center , Tel Aviv , Israel
| | - Itzhak Shapira
- b Sackler Faculty of Medicine , Tel Aviv University , Tel-Aviv , Israel
| | - Sholomo Berliner
- b Sackler Faculty of Medicine , Tel Aviv University , Tel-Aviv , Israel.,e Internal Medicine "E" Tel Aviv Sourasky Medical Center , Tel Aviv , Israel
| | - Ori Rogowski
- b Sackler Faculty of Medicine , Tel Aviv University , Tel-Aviv , Israel.,d Internal Medicine "C" Tel Aviv Sourasky Medical Center , Tel Aviv , Israel
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Abstract
The prognosis of patients with classical Hodgkin lymphoma following chemo- and radiotherapy has been excellent during the last 4 decades. However, the development of secondary malignancies is of major concern. Therefore, the reduction of radiotherapy application is a major objective of ongoing clinical trials. De-escalation of treatment may increase the risk of relapses and thus may lead to reappearance of prognostic factors. Prognostic biomarkers might help to identify patients who are at increased risk of relapse. This review summarizes the current knowledge about potential prognostic biomarkers for patients with classical Hodgkin lymphoma.
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Affiliation(s)
- Martin S Staege
- a Department of Pediatrics , Martin Luther University Halle-Wittenberg , Halle , Germany
| | - Stefanie Kewitz
- a Department of Pediatrics , Martin Luther University Halle-Wittenberg , Halle , Germany
| | - Toralf Bernig
- a Department of Pediatrics , Martin Luther University Halle-Wittenberg , Halle , Germany
| | - Caspar Kühnöl
- a Department of Pediatrics , Martin Luther University Halle-Wittenberg , Halle , Germany
| | - Christine Mauz-Körholz
- a Department of Pediatrics , Martin Luther University Halle-Wittenberg , Halle , Germany
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Expression of dual-specificity phosphatase 5 pseudogene 1 (DUSP5P1) in tumor cells. PLoS One 2014; 9:e89577. [PMID: 24651368 PMCID: PMC3949351 DOI: 10.1371/journal.pone.0089577] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Accepted: 01/21/2014] [Indexed: 01/03/2023] Open
Abstract
Sequencing of individual clones from a newly established cDNA library from the chemoresistant Hodgkin's lymphoma cell line L-1236 led to the isolation of a cDNA clone corresponding to a short sequence from chromosome 1. Reverse transcriptase-polymerase chain reaction indicated high expression of this sequence in Hodgkin's lymphoma derived cell lines but not in normal blood cells. Further characterization of this sequence and the surrounding genomic DNA revealed that this sequence is part of a human endogenous retrovirus locus. The sequence of this endogenous retrovirus is interrupted by a pseudogene of the dual specificity phosphatase 5 (DUSP5). Reverse transcriptase-polymerase chain reaction revealed high expression of this pseudogene (DUSP5P1) in HL cell lines but not in normal blood cells or Epstein-Barr virus-immortalized B cells. Cells from other tumor types (Burkitt's lymphoma, leukemia, neuroblastoma, Ewing sarcoma) also showed a higher DUSP5P1/DUSP5 ratio than normal cells. Furthermore, we observed that higher expression of DUSP5 in relation to DUSP5P1 correlated with the expression of the pro-apoptotic factor B cell leukemia/lymphoma 2-like 11 (BCL2L11) in peripheral blood cells and HL cells. Knock-down of DUSP5 in HL cells resulted in down-regulation of BCL2L11. Thus, the DUSP5/DUSP5P1 system could be responsible for regulation of BCL2L11 leading to inhibition of apoptosis in these tumor cells.
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