Prognostic value of baseline C-reactive protein in diffuse large B-cell lymphoma: a systematic review and meta-analysis

BACKGROUND: C-reactive protein (CRP) is an inflammatory marker of great significance for progression and prognosis of diffuse large B-cell lymphoma (DLBCL). However, previous studies reported the inconsistent findings of the relationship between CRP levels and survival in DLBCL patients. This meta-analysis was performed to investigate the predictive value of baseline CRP in the prognosis of DLBCL. METHODS: Relevant studies on baseline CRP and prognosis of DLBCL were searched from PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, and other databases. The search time was from establishment of the database to December 2022. The studies that reported the baseline CRP level, DLBCL confirmed by pathology, data on the relationship between CRP and overall survival (OS) or progression-free survival (PFS), and published in English or Chinese were included in this meta-analysis. No evidence showed the risk of bias of the included studies. Random-effects meta-analysis were conducted to calculate hazard ratio (HR). Stata15.0 software was used for the meta-analysis. RESULTS: A total of 11 studies with 2,314 patients were included. All included studies were of high quality. The result of prognosis in patients with CRP and DLBCL was HR =2.48 [95% confidence interval (CI): 1.52 to 4.07]. The subgroup analysis showed that the risk of death was higher in both groups (HR =2.58, 95% CI: 2.10 to 3.18, random effects model I(2)=39.7%). There was a significant difference between group 1 and group 2 (P=0.000). CONCLUSIONS: Current evidence suggests that baseline CRP is a potential predictor of DLBCL patients and has potential prognostic value in clinical practice, improving the survival rate and quality of life of DLBCL patients. Additionally, OS appears to be strongly influenced by potential country specific differences, which may be related to racial differences and specific lifestyles.