evaluating the pre-transplant serum levels of c-reactive protein as a prognostic factor for allogeneic hematopoietic stem cell transplantation outcomes

Background :allogeneic hematopoietic stem cell transplantation (allo-hsct) is a potentially curative therapeutic approach for hematological malignancies. it has been suggested that pre-transplant c-reactive protein (crp) assessment may have prognostic value in allo-hsct recipients. objectives :this study aimed to investigate the determinants influencing pre-transplant crp levels in patients undergoing allo-hsct and to evaluate the association between this biomarker and transplantation outcomes, as well as the relationship between certain risk factors and crp levels. methods :a total of 201 patients who underwent allo-hsct were selected for this retrospective study. the predictive value of crp for acute graft-versus-host disease (agvhd) and overall survival (os) was evaluated using receiver-operating characteristic (roc) analysis. the associations between pre-transplant serum crp levels and transplantation outcomes — including agvhd incidence and os — as well as between specific risk factors and crp levels, were analyzed using logistic and cox regression models. results :despite the poor prognostic power of the determined cut-off [area under curve (auc): 59.1% (43.6 - 74.5) for agvhd; auc: 57.2% (47.5 - 66.8) for os], our findings indicate that elevated pre-transplant crp levels are significantly associated with increased agvhd incidence [adjusted odds ratio (aor): 1.86, 95% confidence interval (ci, 1.44 - 9.18), p = 0.05] and a non-significant trend toward worse os [adjusted hazard ratio (ahr): 2.74, 95% ci (1.02 - 7.38), p = 0.11]. additionally, a statistically significant association was observed between elevated crp levels and administration of antithymocyte globulin (atg) as part of the prophylaxis regimen. conclusions :the results suggest that pre-transplant crp levels could potentially serve as a prognostic biomarker for predicting higher agvhd incidence and inferior os. the allo-hsct remains an established therapeutic modality in hematological malignancies.