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Serum tumor necrosis factor-α and interleukin-10 levels as markers to predict outcome of patients with chronic lymphocytic leukemia in different risk groups defined by the IGHV mutation status.
- Source :
-
Archivum immunologiae et therapiae experimentalis [Arch Immunol Ther Exp (Warsz)] 2012 Dec; Vol. 60 (6), pp. 477-86. Date of Electronic Publication: 2012 Sep 04. - Publication Year :
- 2012
-
Abstract
- Tumor necrosis factor (TNF)-α and interleukin (IL)-10 are cytokines involved in the balance between cell-mediated and humoral immunity. We investigated whether serum TNF-α and IL-10 levels have any impact on clinical outcome of patients with chronic lymphocytic leukemia (CLL). TNF-α and IL-10 levels were determined in the serum of 160 CLL patients at the time of diagnosis. The cytokine low-risk group consisted of patients with either TNF-α and IL-10 levels below their medians or those with only one elevated parameter. Both TNF-α and IL-10 levels greater than or equal to their medians defined the cytokine high-risk group. The high-risk patients presented a shorter 3-year treatment-free survival (TFS) than low-risk subjects (15 vs. 69.6 %; p < 0.0001). The high-risk group (p = 0.0002) along with high leukocyte count (p < 0.0001) and unmutated immunoglobulin heavy-chain variable region genes (p < 0.0001) independently predict the risk of progression in patients with Rai stage 0-II. Furthermore, the high-risk group had an independent prognostic impact on shorter TFS both in patients with mutated (24.3 vs. 78.2 %; p < 0.0001) and unmutated (8.2 vs. 49 %; p = 0.004) immunoglobulin heavy-chain variable region genes (IGHV) as compared to the low-risk group. The estimated 5-year overall survival (OS) of high-risk patients was shorter than those in the low-risk group (83.3 vs. 97.1 %; p = 0.003). Multivariate analysis demonstrated the cytokine high-risk group (p = 0.02) followed by Rai stage III-IV (p = 0.048) to be independent factors predicting shorter OS. At diagnosis, TNF-α and IL-10 may predict the outcome of patients with CLL.
- Subjects :
- Antineoplastic Combined Chemotherapy Protocols therapeutic use
Chi-Square Distribution
DNA Mutational Analysis
Disease-Free Survival
Enzyme-Linked Immunosorbent Assay
Female
Humans
Kaplan-Meier Estimate
Leukemia, Lymphocytic, Chronic, B-Cell blood
Leukemia, Lymphocytic, Chronic, B-Cell diagnosis
Leukemia, Lymphocytic, Chronic, B-Cell drug therapy
Leukemia, Lymphocytic, Chronic, B-Cell mortality
Logistic Models
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Proportional Hazards Models
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Up-Regulation
Biomarkers, Tumor blood
Immunoglobulin Heavy Chains genetics
Immunoglobulin Variable Region genetics
Interleukin-10 blood
Leukemia, Lymphocytic, Chronic, B-Cell genetics
Leukemia, Lymphocytic, Chronic, B-Cell immunology
Mutation
Tumor Necrosis Factor-alpha blood
Subjects
Details
- Language :
- English
- ISSN :
- 1661-4917
- Volume :
- 60
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Archivum immunologiae et therapiae experimentalis
- Publication Type :
- Academic Journal
- Accession number :
- 22945689
- Full Text :
- https://doi.org/10.1007/s00005-012-0197-7