Bao Changqian, Zhou De, Zhu Lixia, Qian Wenbin, Ye Xiujin
Department of Hematology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
Program in Clinical Medicine, Zhejiang University School of Medicine, Hangzhou 310058, China.
Transl Cancer Res. 2020 Apr;9(4):2378-2389. doi: 10.21037/tcr.2020.03.49.
Extranodal natural killer/T-cell lymphoma (ENKTL) is a rare subtype of non-Hodgkin lymphoma (NHL), characterized as mature T- and natural killer (NK)-cell lymphoma, which is more common in East Asia and Latin America than in other parts of the world. The overproduction of proinflammatory cytokines such as interleukin-6 (IL-6) plays an essential role in the development of lymphoma.
We measured serum IL-6 and IL-6 related cytokines of 65 newly diagnosed ENKTL patients to assess biomarkers for prognosis of ENKTL.
Patients with high IL-6 (>15.920 mg/L) at diagnosis had more adverse clinical features. Patients with low IL-6 (≤15.920 mg/L) at diagnosis had better progression-free survival (PFS; P=0.002), overall survival (OS; P<0.001), and higher complete remission rates (P=0.001). IL-6 correlated with lactate dehydrogenase (LDH), ferritin, C-reactive protein (CRP), interleukin-10 (IL-10), and tumor necrosis factor-α (TNF-α). Multivariate analysis revealed Ann Arbor stage [P=0.001, risk ratio (RR) =6.011 (2.102-17.191)] and IL-6 [P=0.012, RR =2.367 (1.206-4.643)] to be independent prognostic factors for PFS. Multifactor analysis of OS revealed Ann Arbor stage [P=0.015, RR =3.600 (1.278-10.141)], IL-6 [(P=0.001), RR =3.565 (1.720-7.390)], and chemotherapy that not containing L-asparaginase [(P=0.009, RR =2.717 (1.252-5.780)] to be independent prognostic factors for shorter OS.
These results suggest serum IL-6 at diagnosis is predictive of prognosis for ENKTL, and IL-6 increase is activity during the pathogenesis of ENKTL and offers new insight into potential therapeutic strategies.
结外自然杀伤/T细胞淋巴瘤(ENKTL)是非霍奇金淋巴瘤(NHL)的一种罕见亚型,其特征为成熟T细胞和自然杀伤(NK)细胞淋巴瘤,在东亚和拉丁美洲比世界其他地区更为常见。白细胞介素-6(IL-6)等促炎细胞因子的过度产生在淋巴瘤的发展中起重要作用。
我们检测了65例新诊断的ENKTL患者的血清IL-6及IL-6相关细胞因子,以评估ENKTL预后的生物标志物。
诊断时IL-6水平高(>15.920mg/L)的患者具有更多不良临床特征。诊断时IL-6水平低(≤15.920mg/L)的患者无进展生存期(PFS;P=0.002)、总生存期(OS;P<0.001)更好,完全缓解率更高(P=0.001)。IL-6与乳酸脱氢酶(LDH)、铁蛋白、C反应蛋白(CRP)、白细胞介素-10(IL-10)和肿瘤坏死因子-α(TNF-α)相关。多因素分析显示,Ann Arbor分期[P=0.001,风险比(RR)=6.011(2.102-17.191)]和IL-6[P=0.012,RR=2.367(1.206-4.643)]是PFS的独立预后因素。OS的多因素分析显示,Ann Arbor分期[P=0.015,RR=3.600(1.278-10.141)]、IL-6[(P=0.001),RR=3.565(1.720-7.390)]以及不含L-天冬酰胺酶的化疗[(P=0.009,RR=2.717(1.252-5.780)]是OS缩短的独立预后因素。
这些结果表明,诊断时的血清IL-6可预测ENKTL的预后,IL-6升高在ENKTL发病机制中具有活性,并为潜在治疗策略提供了新的见解。