# CRP patterns and clinical associations in febrile patients undergoing autologous bone marrow transplant: experience from the sole transplant center in the West Bank, Palestine

## TL;DR

This study examines CRP patterns and fever in bone marrow transplant patients in Palestine, finding predictable inflammatory trends and the potential of CRP as a monitoring tool.

## Contribution

The study provides a descriptive analysis of CRP and fever dynamics in a unique regional transplant center, highlighting clinical correlations.

## Key findings

- CRP peaks around day 8 in febrile auto-BMT patients, then declines gradually.
- CRP levels vary significantly by cancer type and conditioning regimen but not by age or gender.
- WBC engraftment timing correlates moderately with fever duration and resolution.

## Abstract

Autologous bone marrow transplantation (auto-BMT) is frequently complicated by febrile episodes and systemic inflammation, particularly during the neutropenic phase, making inflammatory markers such as C-reactive protein (CRP) valuable for monitoring recovery and guiding clinical decisions. In this descriptive, retrospective study of 244 febrile auto-BMT patients in the West Bank, data on demographics, CRP levels (days 1–14), fever onset and duration, and white blood cell (WBC) engraftment were analyzed using non-parametric tests and Spearman correlation. Fever typically began around day 6.7, lasted 6.5 days, and was accompanied by a CRP peak on day 8 (mean 104.8 mg/L) before gradually declining, while WBC engraftment occurred on day 12.96 (SD ± 5.29). CRP levels significantly differed by cancer type and conditioning regimen (p < .001), but not by gender, age, or comorbidities, and were weakly correlated with fever duration and negatively with fever onset. WBC engraftment day showed moderate correlations with fever duration and end. These findings suggest that CRP and fever patterns follow a predictable inflammatory course peaking around day 8, with engraftment timing significantly affecting fever duration, underscoring CRP’s potential as a supportive biomarker for post-transplant monitoring.