The
acute phase reaction is a systemic response to acute or chronic
inflammation. The serum level of
C-reactive protein (CRP) is the only acute phase
biomarker widely used in routine clinical practice, including its uses for prognostics and
therapy monitoring in
cancer patients. Although
Interleukin 6 (
IL6) is a main trigger of the acute phase reactions, a series of
acute phase reactants can contribute (e.g., other members in
IL6 family or IL1 subfamily, and
tumor necrosis factor α). However, the experience from patients receiving intensive
chemotherapy for
hematological malignancies has shown that, besides CRP, other
biomarkers (e.g.,
cytokines, soluble
cytokine receptors, soluble adhesion molecules) also have altered systemic levels as a part of the
acute phase reaction in these immunocompromised patients. Furthermore, CRP and white blood cell counts can serve as a dual prognostic predictor in solid
tumors and
hematological malignancies. Recent studies also suggest that
biomarker profiles as well as alternative inflammatory mediators should be further developed to optimize the predictive utility in
cancer patients. Finally, the experience from allogeneic
stem cell transplantation suggests that selected
acute phase reactants together with specific markers of organ damages are useful for predicting or diagnosing
graft versus host disease.
Acute phase proteins may also be useful to identify patients (at risk of) developing severe immune-mediated toxicity after anticancer
immunotherapy. To conclude, future studies of acute phase predictors in human
malignancies should not only investigate the conventional inflammatory mediators (e.g., CRP, white blood cell counts) but also combinations of novel inflammatory parameters with specific markers of organ damages.