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Near-Patient Testing: The Advantages of C-Reactive Protein in Hematological Testing


Professor Jean-Francois Rossi
Medical Hematology and Oncology
CHU Lapeyronie, Montpellier

C-reactive protein (CRP) is an acute-phase protein that has long been recognized as a marker of systemic inflammation. CRP measurement can complement a range of diagnostic markers to monitor infection and direct treatment. However, as economic rationalization becomes a necessity throughout the health care sector, it is apparent that such areas of frequent laboratory testing may need careful consideration and revision. Hematology is just one of these areas that deserve attention. We assess whether near-patient testing can reduce costs and improve patient diagnosis, treatment and recovery time.

Complete Blood Count (CBC) and CRP measurement are two possible hematological tests that could be relocated from the clinical laboratory to the patients bedside. CBC forms an integral part of hematology and guides numerous therapeutic interventions. CRP, an acute phase plasma protein, is involved in the innate inflammatory response and is a well known marker of systemic inflammation. CRP is secreted rapidly, within a few hours of the immunological insult, upon activation by specific cytokines. CRP is, therefore, a particularly sensitive and interesting tool for monitoring inflammatory conditions and has numerous clinical applications. CRP measurement is used in the monitoring of adult and neonatal infection and immune disorders, and is also an approved risk marker for cardiovascular disease.

Clinical situations:

CBC and CRP measurement are useful tests which are carried out, on average, 15 times during the period of a patients hospitalization, particularly during intensive chemotherapy, with subsequent threat of infection and possible need for blood transfusion.

Aplasia:

Bone marrow aplasia is confirmed by evidence of pancytopenia determined by CBC testing. The severity of the bone m
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