Vallance Kelly, Yang Jie, Li Jiang, Crabtree Valerie McLaughlin, Hinds Pamela S, Mandrell Belinda N
Department of Hematology/Oncology, Cook Children's Medical Center, Fort Worth, TX, USA.
Oncol Nurs Forum. 2011 Sep;38(5):E365-72. doi: 10.1188/11.ONF.E365-E372.
PURPOSE/OBJECTIVES: To explore an association between sleep quality in children and adolescents undergoing therapy for acute lymphoblastic leukemia (ALL) and polymorphisms in two proinflammatory cytokines, interleukin-6 (IL-6) and tumor necrosis factor (TNF).
Retrospective exploratory analysis using data from a multi-institutional prospective study comparing objective sleep measures by actigraphy over 10 days with retrospective genotyping of IL-6 (-174GC) and TNF (-308GA).
Pediatric oncology centers in the southeastern and southwestern United States and in Canada.
88 children or adolescents with ALL.
Secondary analysis of 88 patients (ages 5-18) with sleep quality measured by actigraphy over 10 days in their home environment and retrospective DNA genotyping.
Sleep variables and genotype.
IL-6 promoter (-174G>C) C allele was associated with fewer total daily sleep minutes (p = 0.028) and fewer daily nap minutes (p < 0.01). Patients with the TNF genotype AA had 28.2 more minutes of wake after sleep onset (p = 0.015), 3.4 more nocturnal wake episodes (p = 0.026), and a 5% lower sleep efficiency rate (p = 0.03) than their GA genotype counterparts.
Patients with the TNF (-308G>A) or IL-6 (-174G>C) polymorphisms demonstrated disturbed sleep. This study is the first to find a relationship between these two cytokines and disturbed sleep in children and adolescents with cancer.
Disturbed sleep among pediatric patients with cancer is multifactoral and includes interactions among environment, medications, and genotype. Additional research should explore serum proinflammatory cytokine levels and the influence of mood and worry on sleep.
目的/目标：探讨接受急性淋巴细胞白血病（ALL）治疗的儿童和青少年的睡眠质量与两种促炎细胞因子白细胞介素-6（IL-6）和肿瘤坏死因子（TNF）基因多态性之间的关联。
回顾性探索性分析，使用来自一项多机构前瞻性研究的数据，该研究将通过活动记录仪进行的10天客观睡眠测量与IL-6（-174G>C）和TNF（-308G>A）的回顾性基因分型进行比较。
美国东南部和西南部以及加拿大的儿科肿瘤中心。
88例ALL儿童或青少年。
对88例患者（年龄5 - 18岁）进行二次分析，在其家庭环境中通过活动记录仪测量10天的睡眠质量，并进行回顾性DNA基因分型。
睡眠变量和基因型。
IL-6启动子（-174G>C）的C等位基因与每日总睡眠时间减少（p = 0.028）和每日午睡时间减少（p < 0.01）相关。TNF基因型为AA的患者比GA基因型的患者睡眠开始后清醒时间多28.2分钟（p = 0.015）夜间清醒发作多3.4次（p = 0.026），睡眠效率率低5%（p = 0.03）。
具有TNF（-308G>A）或IL-6（-174G>C）基因多态性的患者睡眠受到干扰。本研究首次发现这两种细胞因子与癌症儿童和青少年睡眠障碍之间的关系。
癌症儿科患者的睡眠障碍是多因素的，包括环境、药物和基因型之间的相互作用。进一步的研究应探索血清促炎细胞因子水平以及情绪和担忧对睡眠影响。
