Lai Raymond, O'Brien Susan, Maushouri Taghi, Rogers Anna, Kantarjian Hagop, Keating Micheal, Albitar Maher
Department of Hematopathology, The University of Texas M. D. Anderson Cancer Center, Houston 77030-4095, USA.
Cancer. 2002 Sep 1;95(5):1071-5. doi: 10.1002/cncr.10772.
Interleukin 6 (IL-6) is a B-cell growth and differentiation factor, which may promote the growth of B-cell neoplasms. In chronic lymphocytic leukemia (CLL) patients, IL-6 plasma levels increased in a stage-dependent manner, suggesting that IL-6 may be a useful prognostic marker. The purpose of this study is to fully assess the prognostic value of IL-6 in CLL patients.
We measured the plasma levels of IL-6 in 100 CLL patients using an enzyme-linked immunoassay method.
Increasing levels of IL-6 significantly correlated with patient age, severity of anemia, Rai stage, white cell count, and beta-2-microglobulin (beta-2M). Although CLL patients did not differ significantly from the normal controls in the median IL-6 plasma level (P = 0.38), patients with advanced diseases (defined by Rai stage III/IV or beta-2M > 3.5) had a significantly higher median IL-6 plasma level than the normal controls (P < 0.05). Furthermore, in patients with advanced diseases, Cox regression hazards model showed that a higher IL-6 level correlated with shorter survival (P = 0.0001). Using IL-6 level of 3 pg/mL as a cutoff, patients with low IL-6 levels had a significantly longer overall survival than those with high IL-6 levels (log rank test, P = 0.002). In patients with CD38-positive CLL, patients with high IL-6 levels (> 3 pg/mL) had significantly shorter survival (P = 0.03). To conclude, IL-6 is a particularly useful predictor for survival in CLL patients with advanced diseases.
Our findings suggest that patients with advanced-stage CLL as well as high IL-6 plasma levels may require aggressive therapeutic approaches and special consideration for experimental therapy.
白细胞介素6（IL-6）是一种B细胞生长和分化因子，可能促进B细胞肿瘤的生长。在慢性淋巴细胞白血病（CLL）患者中，IL-6血浆水平呈阶段依赖性升高，提示IL-6可能是一个有用的预后标志物。本研究的目的是全面评估IL-6在CLL患者中的预后价值。
我们采用酶联免疫吸附测定法测量了100例CLL患者的血浆IL-6水平。
IL-6水平升高与患者年龄、贫血严重程度、Rai分期、白细胞计数和β2-微球蛋白（β2M）显著相关。虽然CLL患者的IL-6血浆中位水平与正常对照组无显著差异（P = 0.38），但晚期疾病患者（根据Rai分期III/IV或β2M > 3.5定义）的IL-6血浆中位水平显著高于正常对照组（P < 0.05）。此外，在晚期疾病患者中，Cox回归风险模型显示较高的IL-6水平与较短的生存期相关（P = 0.0001）。以3 pg/mL的IL-6水平作为临界值，IL-6水平低的患者总生存期显著长于IL-6水平高的患者（对数秩检验，P = 0.002）。在CD38阳性的CLL患者中，IL-6水平高（> 3 pg/mL）的患者生存期显著较短（P = 0.03）。总之，IL-6是晚期CLL患者生存期的一个特别有用的预测指标。
我们的研究结果表明，晚期CLL患者以及IL-6血浆水平高的患者可能需要积极的治疗方法，并特别考虑进行实验性治疗。
