Association between increased levels of TNF-alpha, decreased levels of prealbumin and retinol-binding protein, and disease outcome.
We determined whether there is an association between tumor necrosis factor-alpha (TNF-alpha), undernutrition [prealbumin (PA) <160 mg/L, retinol binding protein (RBP) <30 mg/L], disease stage, outcome (death or survival), and race in children with leukemia. TNF-alpha, PA, and RBP were measured in 52 patients (0.8 to 17 years old): 18 African Americans, 34 whites; 27 newly diagnosed (ND), and 25 in clinical remission (CR). Mean levels of TNF-alpha were higher in patients than in 46 healthy children (p < 0.05), but were not different between ND and CR groups. Mean acute phase proteins (APP) were different among groups: ND > CR > controls (p < 0.05). Mean levels of PA and RBP were lower in patients than in controls (p < 0.051, and tended to be higher in CR than in ND patients. African-American patients had lower concentrations of TNF-alpha, PA, and RBP but higher APP than white patients (p < 0.05). CR patients and African-American patients who died tended to have higher levels of TNF-alpha and APP, but lower PA and RBP than those who survived. A higher percentage of ND African Americans (45%) than of ND whites (13%) died. Results suggest that undernutrition and inflammation in CR patients and African Americans were associated with poor survival, and that ND African Americans have a poorer outcome than whites independently of TNF-alpha levels.
Kuvibidila
S
S
Louisiana State University Medical Center, Department of Pediatrics, New Orleans 70112, USA.
Yu
L
L
Gardner
R
R
Velez
M
M
Ode
D
D
Warrier
R P
RP
D000209:Acute-Phase Proteins / Q000378:metabolism; D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data; D000704:Analysis of Variance; D002051:Burkitt Lymphoma / Q000097:blood* / Q000208:ethnology; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D015479:Leukemia, Myelomonocytic, Acute / Q000097:blood* / Q000208:ethnology; D008297:Male; D009752:Nutritional Status; D011228:Prealbumin / Q000378:metabolism*; D011863:Radioimmunoassay; D012177:Retinol-Binding Proteins / Q000378:metabolism*; D016019:Survival Analysis; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*; D044465:White People / Q000706:statistics & numerical data
D000209:Acute-Phase Proteins; D011228:Prealbumin; D012177:Retinol-Binding Proteins; D014409:Tumor Necrosis Factor-alpha