Hematology Clinic, CHU, Nantes, France.
CRCINA, INSERM, Université d'Angers, Université de Nantes, Nantes, France.
Cancer Med. 2021 Jan;10(2):642-648. doi: 10.1002/cam4.3648. Epub 2020 Dec 25.
The aim of this study was to assess the potential impact of the kinetics of serum levels of seven cytokines during induction in acute myeloid leukemia (AML) patients. Indeed, the role of cytokines, in the pathophysiology and response to therapy of AML patients, remains under investigation. Here, we report on the impact of peripheral levels of two cytokines, the Fms-like tyrosine kinase 3 ligand (FL) and interleukin-6 (IL-6), evaluated during first-line intensive induction. A new risk stratification can be proposed, which supersedes the ELN 2017 classification to predict survivals in AML patients by examining the kinetic profile of these cytokines during the induction phase. It segregates three groups of, respectively, high-risk, characterized by a stagnation of low FL levels, intermediate risk, with dynamic increasing FL levels and high IL-6 at day 22, and favorable risk with increasing FL levels but low IL-6 at day 22.
本研究旨在评估急性髓细胞白血病(AML)患者诱导期血清中七种细胞因子动力学对预后的潜在影响。细胞因子在 AML 患者的病理生理学和治疗反应中的作用仍在研究中。本研究报告了在一线强化诱导期评估的两种细胞因子,即 Fms 样酪氨酸激酶 3 配体(FL)和白细胞介素 6(IL-6)外周水平的影响。通过检查诱导期这些细胞因子的动力学特征,可以提出一种新的风险分层,取代 ELN 2017 分类,以预测 AML 患者的生存率。该分层将患者分为三组,分别为高风险组,其特征为 FL 水平停滞低水平;中风险组,FL 水平呈动态增加,第 22 天 IL-6 水平高;低风险组,FL 水平增加,但第 22 天 IL-6 水平低。