Prognostic value of serum C-reactive protein in idiopathic Multicentric Castleman disease and construction of a prognostic model for patients

Zhixiang Lei ^1* Ya Wang ¹ Tiantian Yu ² Yiting Zhang ³ Wenting Cui ⁴ Cancan Luo ⁵ Qing-Qing Luo ¹ Lili Zhou ¹ Yuchen Gao ¹ Yu Li ⁵

• ¹ Nanchang University, Nanchang, China
• ² Second Hospital of Nanchang, Nanchang, Jiangxi Province, China
• ³ Jiangxi Provincial Children's Hospital, Nanchang, Jiangxi Province, China
• ⁴ Jiujiang First People's Hospital, Jiujiang, Jiangxi Province, China
• ⁵ Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China

Idiopathic Multicentric Castleman disease (iMCD) is a type of the rare lymphoproliferative diseases. C-reactive protein (CRP) is a well-recognized biomarker of inflammation, frequently exhibits elevated levels in individuals diagnosed with iMCD. However, its prognostic value of this factor in iMCD remains uncertain. We retrospectively analyzed 68 patients with iMCD from 6 medical institutions. Using the Kaplan-Meier method, our analysis suggested that a higher serum CRP level (>26.8 mg/L) was associated with worse overall survival in patients (p = 0.004). We developed a multivariable prognostic model based on serum CRP levels to assess survival outcomes in iMCD. The discriminative performance of the model for mortality events was validated through calibration plots and receiver operating characteristic (ROC) curves highlighting CRP as a key biomarker associated with disease prognosis. Additionally, analyzing by chi-square test and Fisher's exact test showed that age, B-symptoms, hypoalbuminemia, ECOG and plasma cell type were significantly associated with high serum CRP level in patients with iMCD, and that fibrinogen levels was positively correlated with CRP level.