title: Racial/ethnic disparities in inflammatory gene single-nucleotide polymorphisms as predictors of a high risk for symptom burden in patients with multiple myeloma 1 year after diagnosis.
abstract: BACKGROUND
  This study was conducted to determine whether any regulatory single-nucleotide polymorphism (SNP) in an inflammatory gene was associated with a high symptom burden in patients 1 year after the diagnosis of multiple myeloma (MM).
  
  
  METHODS
  MM patients rated symptoms with the MD Anderson Symptom Inventory multiple myeloma module (MDASI-MM) and provided buccal-swab DNA samples. SNPs for 4 cytokine genes (interleukin 6 [IL6] -174G>C, IL1β -511C>T, tumor necrosis factor α [TNFα] -308G>A, and IL10 -1082G>A) were tested. Logistic regression models were used to identify SNPs that might predict moderate/severe symptoms (rated ≥ 4 on the MDASI-MM 0-10 scale). For the evaluation of the relationship between SNPs and overall symptom burden, a 2-step cluster analysis was used to divide patients into subgroups with high or low symptom levels.
  
  
  RESULTS
  Forty-one percent of the 344 patients enrolled had a high overall symptom burden. The most prevalent moderate/severe symptoms were fatigue (47%), pain (42%), numbness (38%), and bone aches (32%). For non-Hispanic whites, the IL1β -511 CC genotype was associated with a high overall symptom burden (odds ratio [OR], 2.35; 95% confidence interval [CI], 1.25-4.72; P = .004), whereas the IL6 -174 GG genotype predicted less moderate/severe fatigue (OR, 0.53; 95% CI, 0.29-0.88; P = .013). For other patients, the IL6 -174 GG genotype predicted moderate/severe pain (OR, 3.36; 95% CI, 1.23-13.64; P = .010).
  
  
  CONCLUSIONS
  These results support growing evidence showing that inflammation is associated with cancer-related symptoms, and they suggest that racial/ethnic factors contribute to this association.
authors.affiliation: Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Qiuling
authors.initials: Q
authors.lastname: Shi
authors.forename: Xin Shelley
authors.initials: XS
authors.lastname: Wang
authors.forename: Guojun
authors.initials: G
authors.lastname: Li
authors.forename: Nina D
authors.initials: ND
authors.lastname: Shah
authors.forename: Robert Z
authors.initials: RZ
authors.lastname: Orlowski
authors.forename: Loretta A
authors.initials: LA
authors.lastname: Williams
authors.forename: Tito R
authors.initials: TR
authors.lastname: Mendoza
authors.forename: Charles S
authors.initials: CS
authors.lastname: Cleeland
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004273:DNA, Neoplasm / Q000235:genetics; D005006:Ethnicity / Q000235:genetics*; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D006801:Humans; D007249:Inflammation / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism; D018836:Inflammation Mediators / Q000032:analysis / Q000378:metabolism*; D016753:Interleukin-10 / Q000235:genetics; D053583:Interleukin-1beta / Q000235:genetics; D015850:Interleukin-6 / Q000235:genetics; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications / Q000208:ethnology* / Q000235:genetics*; D016133:Polymerase Chain Reaction; D020641:Polymorphism, Single Nucleotide / Q000235:genetics*; D011379:Prognosis; D011446:Prospective Studies; D044469:Racial Groups; D012720:Severity of Illness Index; D014409:Tumor Necrosis Factor-alpha / Q000235:genetics
chemical_list: D004273:DNA, Neoplasm; C508609:IL10 protein, human; C508600:IL6 protein, human; D018836:Inflammation Mediators; D053583:Interleukin-1beta; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10
keywords: MD Anderson Symptom Inventory (MDASI); SNP; inflammatory gene; multiple myeloma; racial/ethnic variation; symptom