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- Title
Serum interleukin-6 predicts the development of multiple symptoms at nadir of allogeneic hematopoietic stem cell transplantation.
- Authors
Xin Shelley Wang; Qiuling Shi; Williams, Ion A.; Cleeland, Charles S.; Mobley, Gary M.; Reuben, James M.; Bang-Ning Lee; Giralt, Sergio A.; Wang, Xin Shelley; Shi, Qiuling; Williams, Lori A; Lee, Bang-Ning
- Abstract
<bold>Background: </bold>During the time of lowest white blood cell count (nadir) of allogeneic hematopoietic stem cell transplantation (allo-HSCT), cancer patients suffer from tremendous symptom burden related to therapy that requires intensive patient care. However, the mechanism underlying the development of multiple symptoms has not been established.<bold>Methods: </bold>To explore the role of inflammatory cytokines in the development of treatment-related symptoms, we studied dynamic changes in symptoms and in serum concentrations of inflammatory cytokines (interleukin [IL]-6, IL-8, soluble tumor necrosis factor receptor 1 [sTNF-R1], IL-1 receptor antagonist, and IL-12p40p70) from pretherapy throughout the first 30 days of allo-HSCT in 30 patients with acute myelogenous leukemia or myelodysplastic syndrome. We measured multiple symptoms repeatedly using the M. D. Anderson Symptom Inventory. Mixed-effects modeling was used to analyze longitudinal data.<bold>Results: </bold>In response to conditioning and stem-cell infusion, serum levels of IL-6 and the severity of multiple symptoms increased rapidly and peaked at nadir. From baseline to nadir (approximately Day 8 post-transplantation), increase in IL-6 was significantly associated with worsening of the most severe symptoms (fatigue, poor appetite, pain, drowsiness, dry mouth, and disturbed sleep; P< .01). During the first 30 days after transplantation, increases in IL-6 (P< .001) and sTNF-R1 (P< .05) significantly predicted the increasing severity of these symptoms.<bold>Conclusions: </bold>These results suggest that release of systemic inflammatory cytokines, mainly IL-6, corresponds to an increase in treatment-related multiple-symptom burden during the nadir period of allo-HSCT.
- Subjects
UNITED States; CYTOKINES; INTERLEUKIN-6; HEMATOPOIETIC stem cell transplantation; CANCER treatment
- Publication
Cancer (0008543X), 2008, Vol 113, Issue 8, p2102
- ISSN
0008-543X
- Publication type
journal article
- DOI
10.1002/cncr.23820