***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: We previously reported that higher serum concentrations of C-reactive protein ( CRP ) are associated with shorter survival in men with castration-resistant prostate cancer ( CRPC ) . To confirm this finding in an independent data set , we used 119 CRPC patients enrolled in 6 phase II clinical trials and examined the relationship of CRP , alkaline phosphatase , hemoglobin , age , ECOG PS , and prostate specific antigen ( PSA ) with survival . Median follow-up was 19.7 months ( 0.9 - 98.5 months ) , and 89 % have died . After analyzing the form of the risk function using the generalized additive model method , univariate and multivariate Cox proportional hazard models were used to assess associations between baseline individual categorical and continuous variables . Quartiles of CRP were : 0 - 1.0 , 1.1 - 4.9 , 5.0 - 17.0 , and 17.1 - 311 mg/L. In a Cox multivariate model , log(2 ) ( CRP ) ( HR 1.106 , P = 0.013 ) as well as hemoglobin and alkaline phosphatase were independently associated with survival , confirming that higher CRP is associated with shorter survival in CRPC . Since CRP is a marker of inflammation , this finding suggests that inflammation may play an important role in the natural history of advanced prostate cancer . CRP is a readily measurable biomarker that has the potential to improve prognostic models and should be vali date d in a prospect i ve clinical trial Interleukin-6 plays a central role in normal B-cell maturation and in proliferation of some B-cell malignancies including multiple myeloma and some non Hodgkin 's lymphomas ( NHL ) . Furthermore , this cytokine also plays a major role in acute phase response by mediating synthesis of acute phase proteins such as C-reactive protein ( CRP ) . In order to evaluate the exact role of CRP serum level as a simple prognostic factor , we analyzed CRP and IL-6 serum levels in 39 patients with NHL . Eleven patients had low grade NHL , 15 intermediate grade NHL , and 13 high grade NHL . Thirty percent of the patients presented detectable IL-6 serum levels ( mean+/-SD : 33.6+/-95.2 U/ml , range : 0 to 500 ) . Increased serum CRP levels were found in 42 % of the patients with a mean of 29.2+/-41.97 mg/l ] ( range : 0 to 129 ) . Thirty seven patients were studied for both markers . Three groups of patients were determined . One with low IL-6 and CRP serum levels ( N=21 ) , a second with high level of both markers ( N=10 ) , and the third with high serum CRP levels alone ( N = 5 ) . Only one patient had high level of serum IL-6 with no detectable CRP . The correlation of serum IL-6 and CRP levels with patient survival was investigated . Median survival in the group with low IL-6 level was not reached . 67 % of patients of this group were still alive at 32 months from diagnosis . The group of patients with detectable IL-6 had a median of survival of 12 months ( p<0.025 ) . The survival of patients with a CRP<10 mg/l was not reached . 75 % of patients survive at 32 months from diagnosis , whereas the group with higher CRP level reached a median survival at 8.5 months ( p<0.009 ) . As expected , on univariate analysis , there is a significant relationship between CRP and IL-6 levels ( p<0.00017 ) , and CRP levels and B symptoms ( p<0.001 ) . Furthermore there is a significant relationship between CRP and LDH levels (p<0.042).These results indicated that CRP may be considered as a valuable and easy prognostic biomarker of NHL BACKGROUND Sipuleucel-T , an autologous active cellular immunotherapy , has shown evidence of efficacy in reducing the risk of death among men with metastatic castration-resistant prostate cancer . METHODS In this double-blind , placebo-controlled , multicenter phase 3 trial , we r and omly assigned 512 patients in a 2:1 ratio to receive either sipuleucel-T ( 341 patients ) or placebo ( 171 patients ) administered intravenously every 2 weeks , for a total of three infusions . The primary end point was overall survival , analyzed by means of a stratified Cox regression model adjusted for baseline levels of serum prostate-specific antigen ( PSA ) and lactate dehydrogenase . RESULTS In the sipuleucel-T group , there was a relative reduction of 22 % in the risk of death as compared with the placebo group ( hazard ratio , 0.78 ; 95 % confidence interval [ CI ] , 0.61 to 0.98 ; P=0.03 ) . This reduction represented a 4.1-month improvement in median survival ( 25.8 months in the sipuleucel-T group vs. 21.7 months in the placebo group ) . The 36-month survival probability was 31.7 % in the sipuleucel-T group versus 23.0 % in the placebo group . The treatment effect was also observed with the use of an unadjusted Cox model and a log-rank test ( hazard ratio , 0.77 ; 95 % CI , 0.61 to 0.97 ; P=0.02 ) and after adjustment for use of docetaxel after the study therapy ( hazard ratio , 0.78 ; 95 % CI , 0.62 to 0.98 ; P=0.03 ) . The time to objective disease progression was similar in the two study groups . Immune responses to the immunizing antigen were observed in patients who received sipuleucel-T.  Adverse events that were more frequently reported in the sipuleucel-T group than in the placebo group included chills , fever , and headache . CONCLUSIONS The use of sipuleucel-T prolonged overall survival among men with metastatic castration-resistant prostate cancer . No effect on the time to disease progression was observed . ( Funded by Dendreon ; Clinical Trials.gov number , NCT00065442 . 
    Output:
    
Conclusion : This meta- analysis suggests a detrimental impact for CRP on OS in MPC .