The Systemic Inflammatory Response Predicts Overall and Cancer Specific Survival in Patients with Malignant Lymphoma

Background: The value of C-reactive protein concentrations in the assessment of prognosis in patients with advanced lymphoma has not been clearly defined.

Material/methods: Patients with a diagnosis of non-Hodgkin's lymphoma (n = 108) and Hodgkin's lymphoma, (n = 39) and who had measurements of C-reactive protein were studied retrospectively and the data was reviewed over 8 years.

Results: Median survival, from the time of sampling, was 7.4 months. On univariate analysis there was a significant relationship between the duration of cancer specific survival and tumour type (p < 0.05), circulating concentrations of albumin (p < 0.001) and C-reactive protein (p < 0.001). In contrast, only C-reactive protein concentration was a predictor of death from intercurrent disease (p < 0.05). On multivariate analysis, C-reactive protein concentration remained a strong independent predictor of both death from cancer and intercurrent disease (p < 0.001). The hazard ratio associated with a unit increase in stratified C-reactive protein concentration was 8.18 (95% CI 4.80 - 13.95) for cancer specific death and 2.11 (95% CI 1.22 - 3.64) for intercurrent death.

Conclusions: The results of the present study demonstrate that patients with advanced lymphoma have evidence of a systemic inflammatory response and the magnitude of the C-reactive protein response predicts the duration of overall and cancer specific survival.