, Volume 25, Issue 6, pp 335–338 | Cite as

The effects of pretransplant conditioning, graft-versus-host disease and sepsis on the CRP levels in bone marrow transplantation

  • E. Rintala
  • K. Remes
  • J. Nikoskelainen
  • T. T. Salmi
  • P. Koskinen


To evaluate the diagnostic utility of C-reactive protein (CRP) for the detection of sepsis in bone marrow transplantation, CRP levels were analyzed after pretransplant conditioning and variably combined in septic, focal or viral infections with graft-versus-host disease (GvHD) in 64 bone marrow recipients. The CRP levels after pretransplant conditioning were low. The peak levels of CRP were influenced independently by the type of infection (p=0.016; septic and viral infections were significantly different) and GvHD (p=0.003). The area under the receiver-operator characteristic (ROC) curve for peak CRP in sepsis was 0.653 and 0.618 with and without GvHD, respectively. It was concluded that GvHD and the type of infection were independent determinants of the CRP responses. GvHD did not affect the extent of the CRP response. Therefore, although not highly specific for sepsis, CRP remains a useful detector of sepsis in bone marrow transplantation.


Public Health Bone Marrow Internal Medicine Infectious Disease Viral Infection 
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  1. 1.
    Rose, P., Johnson, S., Meakin, M., Mackie, P., Stuart, J. Serial study of C-reactive protein during infection in leukaemia. J. Clin. Pathol. 34 (1981) 263–266.Google Scholar
  2. 2.
    Kostiala, A., Kostiala, I., Valtonen, V., Teerenhovi, L. Levels of C-reactive protein in patients with hematologic malignancies. Scand. J. Infect. Dis. 17 (1985) 407–410.Google Scholar
  3. 3.
    Ligtenberg, P., Hoepelman, I., Oude Sogtoen, G., Dekker, A., van der Tweel, I., Rozenberg-Arska, M., Verhoef, J. C-reactive protein in the diagnosis and management of infections in granulocytopenic and non-granulocytopenic patients. Eur. J. Clin. Microbiol. Infect. Dis. 10 (1991) 25–31.Google Scholar
  4. 4.
    Rintala, E., Irjala, K., Nikoskelainen, J. Value of measurement of C-reactive protein in febrile patients with hematological malignancy. Eur. J. Clin. Microbiol. Infect. Dis. 11 (1992) 973–978.Google Scholar
  5. 5.
    Riikonen, P., Saarinen, U.-M., Teppo, A.-M., Metsärinne, K., Fyhrquist, F., Jalanko, H. Cytokine and acute-phase reactant levels in serum of children with cancer admitted for fever and neutropenia. J. Infect. Dis. 166 (1992) 432–436.Google Scholar
  6. 6.
    Manian, F. A. A prospective study of daily measurement of C-reactive protein in serum of adults with neutropenia. Clin. Infect. Dis. 21 (1995) 114–121.Google Scholar
  7. 7.
    Rintala, E., Pulkki, K., Mertsola, J., Nevalainen, J., Nikoskelainen, J. Endotoxin, interleukin-6 and phospholipase-A2 as markers of sepsis in patients with hematological malignancies. Scand. J. Infect. Dis. 27 (1995) 39–43.Google Scholar
  8. 8.
    Dawson-Saunders, B., Trapp, R. G. Evaluating diagnostic procedures. In:Dawson-Saunders, B., Trapp, R. G. (eds.): Basic and clinical biostatistics. 2nd ed. Appleton & Lange, Norwalk, CT, USA 1994, pp. 232–248.Google Scholar
  9. 9.
    Saarinen, U., Strandjord, S., Warkentin, P., Cheung, N.-K., Lazarus, H., Coccia, P. Differentiation of presumed sepsis from acute graft-versus-host disease by C-reactive protein and serum total IgE in bone marrow transplant patients. Transplantation 44 (1987) 540–546.Google Scholar
  10. 10.
    De Bel, C., Gerritsen, E., de Maaker, G., Moolenaar, A., Vossen, J. C-reactive protein in the management of children with fever after allogeneic bone marrow transplantation. Infection 19 (1991) 92–96.Google Scholar
  11. 11.
    Deodhar, S.D. C-reactive protein: clinical applications in monitoring disease activity. Clin. Immunol. Newsletter 11 (1991) 138–143.Google Scholar
  12. 12.
    Young, B., Gleeson, M., Cripps, A. C-reactive protein: a critical review. Pathology 23 (1991) 118–124.Google Scholar
  13. 13.
    Walker, S., Rogers, T., Riches, P., White, S., Hobbs, J. Value of serum C-reactive protein measurement in the management of bone marrow transplant recipients. Part I: early transplant period. J. Clin. Pathol. 37 (1984) 1018–1021.Google Scholar
  14. 14.
    Tilg, H., Nordberg, J., Vogel, W., Luger, T., Herold, M., Aulitzky, W., Margreiter, R., Huber, C. Circulating levels of interleukin 6 and C-reactive protein after liver transplantation. Transplantation 54 (1992) 142–146.Google Scholar
  15. 15.
    Cohen, D., Benvenisty, A., Meyer, E., Hardy, M. Serum C-reactive protein concentrations in cyclosporine-treated renal allograft recipients. Transplantation 45 (1988) 919–922.Google Scholar

Copyright information

© MMV Medizin Verlag GmbH München 1997

Authors and Affiliations

  • E. Rintala
    • 1
  • K. Remes
    • 1
  • J. Nikoskelainen
    • 1
  • T. T. Salmi
    • 2
  • P. Koskinen
    • 3
  1. 1.Dept. of MedicineTurku University Central HospitalTurkuFinland
  2. 2.Dept. of PediatricsTurku University Central HospitalTurkuFinland
  3. 3.Dept. of Clinical ChemistryTurku University Central HospitalTurkuFinland

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