Longitudinal trajectory patterns of plasma albumin and C-reactive protein levels around diagnosis, relapse, bacteraemia, and death of acute myeloid leukaemia patients

• Main Authors: Kim Oren Gradel, Pedro Póvoa, Olav Sivertsen Garvik, Pernille Just Vinholt, Stig Lønberg Nielsen, Thøger Gorm Jensen, Ming Chen, Ram Benny Dessau, Jens Kjølseth Møller, John Eugenio Coia, Pernille Sanberg Ljungdalh, Annmarie Touborg Lassen, Henrik Frederiksen
• Format: Article
• Language: English
• Published: BMC 2020-03-01
• Series: BMC Cancer
• Subjects: Acute myeloid leukaemia; Plasma albumin; C-reactive protein; Infection; Inflammation
• Online Access: http://link.springer.com/article/10.1186/s12885-020-06754-z

Abstract Background No study has evaluated C-reactive protein (CRP) and plasma albumin (PA) levels longitudinally in patients with acute myeloid leukaemia (AML). Methods We studied defined events in 818 adult patients with AML in relation to 60,209 CRP and PA measures. We investigated correlations between CRP and PA levels and daily CRP and PA levels in relation to AML diagnosis, AML relapse, or bacteraemia (all ±30 days), and death (─30–0 days). Results On the AML diagnosis date (D0), CRP levels increased with higher WHO performance score (PS), e.g. patients with PS 3/4 had 68.1 mg/L higher CRP compared to patients with PS 0, adjusted for relevant covariates. On D0, the PA level declined with increasing PS, e.g. PS 3/4 had 7.54 g/L lower adjusted PA compared to PS 0. CRP and PA levels were inversely correlated for the PA interval 25–55 g/L (R = − 0.51, p < 10–5), but not for ≤24 g/L (R = 0.01, p = 0.57). CRP increases and PA decreases were seen prior to bacteraemia and death, whereas no changes occurred up to AML diagnosis or relapse. CRP increases and PA decreases were also found frequently in individuals, unrelated to a pre-specified event. Conclusions PA decrease is an important biomarker for imminent bacteraemia in adult patients with AML.