C-reactive protein is a strong predictor for anaemia in renal cell carcinoma: role of IL-6 in overall survival.
OBJECTIVE
• To elucidate the association of progression of advanced renal cell carcinoma with anaemia and investigate factors influencing tumor-associated anaemia.


METHODS
• We analyzed different clinical variables to study associations with anaemia in 86 metastatic renal cell carcinoma patients. • 45 (52%) of patients had already developed anaemia prior to therapy.


RESULTS
• Anaemic patients had an increase in the serum markers C-reactive protein (CRP), IL-6 and erythropoietin (EPO). In addition we observed substantial correlation between IL-6 and CRP serum levels (R = 0.639, P < 0.0001). • Univariate logistic regression analysis revealed that patients with IL-6 >10 pg/mL had a considerable increase in risk for anaemia (odds ratio 3.86, P= 0.003). • In addition, patients with CRP >0.7 mg/dL had a very strong increase in risk for anaemia (OR = 14.08, P < 0.0001). • Stepwise multivariate logistic regression analysis confirmed CRP >0.7 mg/mL as the only independent predictor for anaemia. Cox-regression modeling selected serum IL-6 as the strongest independent prognostic indicator (hazard ratio 3.58, P < 0.0001).


CONCLUSIONS
• Anaemia depends on serum IL-6, which is a strong inductor of CRP and regulator of the iron-transport. Serum IL-6 may be considered as a target to treat cancer-related anaemia.
Immunotherapy Unit, Department of Urology, Innsbruck Medical University, Austria. claudia.falkensammer@i-med.ac.at
Claudia E
CE
Falkensammer
Martin
M
Thurnher
Nicolai
N
Leonhartsberger
Reinhold
R
Ramoner
D000368:Aged; D000740:Anemia / Q000209:etiology* / Q000401:mortality; D015415:Biomarkers / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism*; D002292:Carcinoma, Renal Cell / Q000150:complications* / Q000401:mortality; D004812:Epidemiologic Methods; D004921:Erythropoietin / Q000378:metabolism; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000378:metabolism*; D007680:Kidney Neoplasms / Q000150:complications* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011379:Prognosis
D015415:Biomarkers; D015850:Interleukin-6; D004921:Erythropoietin; D002097:C-Reactive Protein