title: Association of interleukin-6 and interleukin-8 with poor prognosis in elderly patients with chronic lymphocytic leukemia.
abstract: In population studies, the relative survival in chronic lymphocytic leukemia (CLL) decreases with age. In this study, we demonstrated in a cohort of 189 patients from a CLL clinic that overall survival was lower in the sub-cohort of patients aged ≥ 70 years, but causes of death were similar for all age groups, being progressive CLL, secondary malignancies and infections. As normal individuals age, the plasma levels of inflammatory cytokines, such as interleukin-6 (IL-6) and IL-8, can increase. In our patients with CLL, IL-6, IL-8 and tumor necrosis factor-α (TNF-α) levels increased with age to a greater degree than in normal individuals, and the levels correlated closely with plasma β(2)-microglobulin and with one another. In addition, in patients ≥ 70 years, IL-6 was found to be a better prognostic marker than immunoglobulin variable heavy chain gene (IgV(H)) status. In vitro studies demonstrated that IL-6 and IL-8 could enhance the binding of CLL cells to stromal cells, suggesting that their clinical activity may be mediated through their effects on the microenvironment. Thus, plasma IL-6 is an important prognostic marker for the elderly with CLL, and this study highlights that the utility of prognostic markers may depend on patient age.
authors.affiliation: Manitoba Institute of Cell Biology, Winnipeg, MB, Canada.
authors.forename: Ju-Yoon
authors.initials: JY
authors.lastname: Yoon
authors.forename: Sandrine
authors.initials: S
authors.lastname: Lafarge
authors.forename: Dave
authors.initials: D
authors.lastname: Dawe
authors.forename: Sunjay
authors.initials: S
authors.lastname: Lakhi
authors.forename: Rajat
authors.initials: R
authors.lastname: Kumar
authors.forename: Carmen
authors.initials: C
authors.lastname: Morales
authors.forename: Aaron
authors.initials: A
authors.lastname: Marshall
authors.forename: Spencer B
authors.initials: SB
authors.lastname: Gibson
authors.forename: James B
authors.initials: JB
authors.lastname: Johnston
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000235:genetics; D007135:Immunoglobulin Variable Region / Q000235:genetics; D015850:Interleukin-6 / Q000097:blood*; D016209:Interleukin-8 / Q000097:blood*; D053208:Kaplan-Meier Estimate; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000097:blood* / Q000175:diagnosis / Q000235:genetics; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009154:Mutation; D011379:Prognosis; D016615:Telomere / Q000235:genetics; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*; D055815:Young Adult; D001613:beta 2-Microglobulin / Q000097:blood*
chemical_list: D007143:Immunoglobulin Heavy Chains; D007135:Immunoglobulin Variable Region; D015850:Interleukin-6; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha; D001613:beta 2-Microglobulin