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

JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY

卷:84

Article

Stoll, Joseph R.¹  Vaidya, Toral S.¹  Mori, Shoko¹  Dusza, Stephen W.¹  Lacouture, Mario E.^1,2  Markova, Alina^1,2 

[1] Mem Sloan Kettering Canc Ctr, Dept Med, Dermatol Serv, New York, NY 10021 USA

[2] Weill Cornell Med Coll, Dept Dermatol, New York, NY USA

关键词: biomarker;    cytokine;    drug-induced hypersensitivity syndrome;    drug rash;    drug reaction;    drug reaction with eosinophilia and systemic symptoms;    graft-versus-host disease;    interleukin-6 (IL-6);    mortality;    severe cutaneous adverse reaction;    survival;    tumor necrosis factor alpha (TNF-alpha);   

DOI  :  10.1016/j.jaad.2020.03.010

来源: Elsevier

【 摘 要 】

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]-alpha) 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-alpha were associated with decreased survival. Overall survivals in patients with elevated levels of IL-6, IL-10, and TNF-alpha 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-alpha 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-alpha 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.

【 授权许可】

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