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骨髓纤维化患者中白细胞介素-8、可溶性白细胞介素-2受体及无免疫球蛋白轻链水平的临床关联及预后意义

Clinical Correlates and Prognostic Significance of IL-8, sIL-2R, and Immunoglobulin-Free Light Chain Levels in Patients with Myelofibrosis.

作者信息

Barabanshikova Maria V, Dubina Irina A, Lapin Sergey V, Morozova Elena V, Vlasova Julia J, Ivanova Maria O, Moiseev Ivan S, Afanasyev Boris V

机构信息

R.M. Gorbacheva Memorial Institute of Children Hematology and Transplantation, State Medical University named I.P. Pavlov, Saint-Petersburg, Russian Federation.

出版信息

Oncol Res Treat. 2017;40(10):574-578. doi: 10.1159/000477253. Epub 2017 Sep 21.

Abstract

BACKGROUND

Chronic myeloproliferative neoplasms are characterized by clonal hematopoiesis and persistent inflammatory reaction. In this study, the clinical significance and prognostic impact of several inflammatory markers were evaluated in patients with BCR/ABL-negative myeloproliferative malignancies.

METHODS

Serum levels of interleukin-8 (IL-8) and lymphoid-associated activation markers - soluble interleukin-2 receptor (sIL-2R) and immunoglobulin-free light chains (FLC) - were evaluated in patients with primary myelofibrosis (MF), post-polycythemia vera MF, and post-essential thrombocythemia MF, and compared with the levels in healthy donors.

RESULTS

In 57 MF patients, sIL-2R excess correlated with transfusion-dependent anemia (p = 0.03) and splenomegaly (p = 0.02). There were no statistically significant correlations between sIL-2R and IL-8 levels, but the plasma concentration of κ-FLC positively correlated with the IL-8 level (p = 0.027). In univariate analysis, increased levels of IL-8 (p = 0.016) and sIL-2R (p = 0.010) significantly reduced 1-year overall survival. Only elevated sIL-2R rate retained significance (p = 0.02) in multivariate analysis when Dynamic International Prognostic Scoring System plus (DIPSSplus) risk stratification was added.

CONCLUSION

We observed an association between FLC and proinflammatory cytokine hyperexpression. Serum cytokine levels and FLC might be a promising approach to predicting and monitoring treatment response in MF patients.

摘要

背景

慢性骨髓增殖性肿瘤的特征为克隆性造血和持续性炎症反应。在本研究中,对几种炎症标志物在BCR/ABL阴性骨髓增殖性恶性肿瘤患者中的临床意义及预后影响进行了评估。

方法

对原发性骨髓纤维化(MF)、真性红细胞增多症后MF和原发性血小板增多症后MF患者的血清白细胞介素-8(IL-8)水平以及淋巴细胞相关激活标志物——可溶性白细胞介素-2受体(sIL-2R)和游离免疫球蛋白轻链(FLC)进行评估,并与健康供者的水平进行比较。

结果

在57例MF患者中,sIL-2R升高与输血依赖型贫血(p = 0.03)和脾肿大(p = 0.02)相关。sIL-2R与IL-8水平之间无统计学显著相关性,但κ-FLC的血浆浓度与IL-8水平呈正相关(p = 0.027)。在单因素分析中,IL-8(p = 0.016)和sIL-2R(p = 0.010)水平升高显著降低1年总生存率。当加入动态国际预后评分系统升级版(DIPSSplus)风险分层时,多因素分析中仅sIL-2R升高率仍具有显著性(p = 0.02)。

结论

我们观察到FLC与促炎细胞因子高表达之间存在关联。血清细胞因子水平和FLC可能是预测和监测MF患者治疗反应的一种有前景的方法。

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