Significance of CRP in pediatric Hodgkin disease aim: To determine usage of CRP in Hodgkin disease as a prognostic and diagnostic parameter

Öz

Materials and Methods: We evaluated the relationship of CRP, with disease stage, presence of B symptom and prognosis in our 20 patients with the diagnosis of Hodgkin disease retrospectively. Results: CRP was high in 10 (50 %) of our cases. None of the patients with the disease stage I, had high CRP. CRP values were above 5 mg/L in 37 %, 83 %, 67 % of the patients stages II, III and IV respectively. It was determined that elevated CRP values and the presence of B symptoms correlated statistically. Three of the cases showed progression and received second line treatment. In all of the cases with progressive disease, CRP values were elevated at the first diagnose. Conclusion: CRP can be a useful marker at diagnosis and follow up of pediatric Hodgkin disease.

Anahtar Kelimeler

• Prognosis,C-Reactive Protein,Hodgkin Disease,Retrospective Studies,Child,Biological Markers

Pediatrik Hodgkin hastalığı'nda CRP'nin önemi

Öz

Amaç: CRP'nin pediatrik Hodgkin hastalığında prognostik ve tanısal bir parametre olarak kullanılabilirliliğini değerlendirmek. Gereç ve Yöntem: 20 Hodgkin olgumuzda tanı sırasındaki CRP değerleri ile hastalığın evresi, B semptomlarının varlığı ve prognozu arasındaki ilişkiyi retrospektif olarak irdeledik. Bulgular: Olgularımızdan 10'unda (% 50) CRP'nin yüksek olduğu saptandı. Evre I'de hiçbir hastada CRP yüksek değildi. Evre II'de ise hastaların % 37'inde, evre III'de % 83'ünde, evre IV'de % 67'sinde CRP değeri 5 mg/L'nin üzerinde idi. İstatistiksel olarak irdelendiğinde CRP yüksekliğinin ileri evre ve B septomlarının varlığı ile paralellik gösterdiği görüldü. Olgularımızın 3'ü progrese olmuşlar ve ikinci seçim tedaviye alınmışlardır. Progrese olguların tamamında tanı sırasında CRP yüksek olarak bulunmuştur. Sonuç: CRP çocukluk çağı Hodgkin hastalığında tanı ve izlemde bir biyomarker olarak yararlı olabilir.

Anahtar Kelimeler

• Seyir,C-reaktif protein,Hodgkin hastalığı,Geriyedönük çalışma,Çocuk,Biyolojik belirteçler

Kaynakça

1. Balou SP, Lozanski G. Introduction of inflammatory cytokines release from cultured human monocytes by C-reactive protein.Cytokine 1992-4.361-368
2. Fassbender K, Dempfle CE, Mielke O, et al
3. Proinflammatorycytokines: Indicators of infection in high risk patients.J Lab Clin Med 1997;130:535- 539. Franke S, Herrmann D, Hein G, et al. Interleukin 6, soluble interleukin-2-receptor, and soluble interleukin-6-receptor in sera of patients with rheumatoid arthritis:Infkuences of disease activity and drug therapy, Eur J Med Res 1997;2:401-406 Herrmann JL, Blanchard H, Brunengo P, et al
4. TNF alpha, IL-1 beta, and IL-6 plasma levels in neutropenic patients after onset of fever and correlation with C reactive protein(CRP) kinetic values.Infection 1994; 22:309-315 Kutukculer N, Çağlayan S, Aydogdu F. Study of proinflammatory (TNF-alpha, IL-1 alpha, IL-6) and T-cefl drived (IL-2JL-4) cytokines in plasma and synoyial fluid of patients with juvenile chronic arthritis: Correlations with clinical and labratory parameters. Clin Rheumatol 1998,17:288-292
5. Child JA, Cooper EH, Illingworth S, et al
6. Biochemical markers in Hodgkin's disease and non-Hogkin's lymphoma. Recent Results Cancer Res 197 8,64.180-189 Legouffe E, Rodroguez C, Picot MC, et al. C reaciive protein serum level is a valuable and simple prognostic marker in non hodgkin's lymphoma.Leuk Lymphoma 1998;31:351-357 Child JA, Spati B, Illingworth S, et al. Serum beta 2 microgloblin and C-reactive protein in monitoring öf lymphomas: Findings in multicenter study and experience in selected patients. Cancer 1980;45:318-326 Tartour E,Deneux L, Mosseri V,et al. Soluble inteleukin-2 receptor serum level as predictor of locoreginal control and survival for patients with head and neck carcinomas: Results of a multivariate prospective study.Cancer 1997;79: 1401-1408 Maccio A, Lai P, Santona MC,et al. High serum levels of soluble IL-2 receptors, cytokines , and C- reactive protein correlate with impairment of T cell response in patients with advanced epithelial ovarian cancer. Gynecol Oncol 1998; 69:248-252 Nozoe T,Matsumata T,Kitamura M, et al. Significance of preoperative elevation of serum C-reactive protein as an indicator for prognosos in colorectal cancer. Am J surg 1998;176:335-338 Zaloudik J,Lauerova L, Janakova L, et al
7. Significance of pretreatment immunological parameters in colorectal cancer patients with unresectable metastases to the liver
8. Hepatogastroenterelogy 1999;46:220-227 Inoue T, Hashimura T, Iwamura H, et al

9. Multivariate analysis of prognostic determinants after surgery for renal cell carcinoma at Himeji National Hospital. Hinyokika Kiyo 200;46:229-234
10. Masuda H, Kurita Y, Fukuta K, etal. Significant prognostic factors for %-year survival after curative resection of renal cell carcinoma. Int J Urol 1998,5:418-422
11. Wieland A, Kerbl R, Berghold A, Schwinger W, Mann G, Urban C. C-reactive protein (CRP) as tumor marker in pediatric and adolescent patients with Hodgkin disease. Med Pediatr Oncol 2003,41:21-25