Association of interleukin-6 and tumor necrosis factor-α with mortality in hospitalized patients with cancer.

Autor: Stoll JR; Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York., Vaidya TS; Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York., Mori S; Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York., Dusza SW; Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York., Lacouture ME; Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Dermatology, Weill Cornell Medical College, New York, New York., Markova A; Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Dermatology, Weill Cornell Medical College, New York, New York. Electronic address: markovaa@mskcc.org.
Jazyk: angličtina
Zdroj: Journal of the American Academy of Dermatology [J Am Acad Dermatol] 2021 Feb; Vol. 84 (2), pp. 273-282. Date of Electronic Publication: 2020 Mar 12.
DOI: 10.1016/j.jaad.2020.03.010
Abstrakt: Background: Severe cutaneous adverse reactions (SCARs) are associated with high morbidity and mortality in patients with cancer. Early identification and treatment of SCARs may improve outcomes.
Objective: To identify biomarkers to predict outcomes in hospitalized patients with cancer who developed SCARs.
Methods: Retrospective review of 144 hospitalized patients with cancer with a morbilliform rash, recorded testing for serum cytokines (interleukin [IL]-6, IL-10, and tumor necrosis factor [TNF]-α) or elafin, and a dermatology consultation. Rashes were categorized as simple morbilliform rash without systemic involvement or complex morbilliform rash with systemic involvement.
Results: Fifty-four of 144 (37.5%) patients died during follow-up. Elevated levels of IL-6, IL-10, and TNF-α were associated with decreased survival. Overall survivals in patients with elevated levels of IL-6, IL-10, and TNF-α were 53.7%, 56.6%, 53.6%, respectively, compared with 85.7%, 82.5% and 83.6%, respectively, in those with lower levels. Patients with increased levels of both IL-6 and TNF-α had a nearly 6-fold increase in mortality (hazard ratio, 5.82) compared with patients with lower levels.
Limitations: Retrospective design, limited sample size, and high-risk population.
Conclusions: Hospitalized patients with cancer with rash and elevated IL-6 and TNF-α were nearly 6 times more likely to die over the course of follow-up. These biomarkers may serve as prognostic biomarkers and therapeutic targets for this high-risk population.
(Copyright © 2020 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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