Association of interleukin-6 and tumor necrosis factor-α with mortality in hospitalized patients with cancer.
Antineoplastic Agents
/ adverse effects
Biomarkers, Tumor
/ blood
Drug Eruptions
/ blood
Female
Follow-Up Studies
Hospital Mortality
Humans
Interleukin-10
/ blood
Interleukin-6
/ blood
Kaplan-Meier Estimate
Male
Middle Aged
Neoplasms
/ blood
Prognosis
Retrospective Studies
Risk Assessment
/ methods
Severity of Illness Index
Tumor Necrosis Factor-alpha
/ blood
biomarker
cytokine
drug rash
drug reaction
drug reaction with eosinophilia and systemic symptoms
drug-induced hypersensitivity syndrome
graft-versus-host disease
interleukin-6 (IL-6)
mortality
severe cutaneous adverse reaction
survival
tumor necrosis factor alpha (TNF-α)
Journal
Journal of the American Academy of Dermatology
ISSN: 1097-6787
Titre abrégé: J Am Acad Dermatol
Pays: United States
ID NLM: 7907132
Informations de publication
Date de publication:
Feb 2021
Feb 2021
Historique:
received:
17
01
2020
revised:
13
02
2020
accepted:
05
03
2020
pubmed:
17
3
2020
medline:
30
7
2021
entrez:
16
3
2020
Statut:
ppublish
Résumé
Severe cutaneous adverse reactions (SCARs) are associated with high morbidity and mortality in patients with cancer. Early identification and treatment of SCARs may improve outcomes. To identify biomarkers to predict outcomes in hospitalized patients with cancer who developed SCARs. Retrospective review of 144 hospitalized patients with cancer with a morbilliform rash, recorded testing for serum cytokines (interleukin [IL]-6, IL-10, and tumor necrosis factor [TNF]-α) or elafin, and a dermatology consultation. Rashes were categorized as simple morbilliform rash without systemic involvement or complex morbilliform rash with systemic involvement. Fifty-four of 144 (37.5%) patients died during follow-up. Elevated levels of IL-6, IL-10, and TNF-α were associated with decreased survival. Overall survivals in patients with elevated levels of IL-6, IL-10, and TNF-α were 53.7%, 56.6%, 53.6%, respectively, compared with 85.7%, 82.5% and 83.6%, respectively, in those with lower levels. Patients with increased levels of both IL-6 and TNF-α had a nearly 6-fold increase in mortality (hazard ratio, 5.82) compared with patients with lower levels. Retrospective design, limited sample size, and high-risk population. Hospitalized patients with cancer with rash and elevated IL-6 and TNF-α were nearly 6 times more likely to die over the course of follow-up. These biomarkers may serve as prognostic biomarkers and therapeutic targets for this high-risk population.
Sections du résumé
BACKGROUND
BACKGROUND
Severe cutaneous adverse reactions (SCARs) are associated with high morbidity and mortality in patients with cancer. Early identification and treatment of SCARs may improve outcomes.
OBJECTIVE
OBJECTIVE
To identify biomarkers to predict outcomes in hospitalized patients with cancer who developed SCARs.
METHODS
METHODS
Retrospective review of 144 hospitalized patients with cancer with a morbilliform rash, recorded testing for serum cytokines (interleukin [IL]-6, IL-10, and tumor necrosis factor [TNF]-α) or elafin, and a dermatology consultation. Rashes were categorized as simple morbilliform rash without systemic involvement or complex morbilliform rash with systemic involvement.
RESULTS
RESULTS
Fifty-four of 144 (37.5%) patients died during follow-up. Elevated levels of IL-6, IL-10, and TNF-α were associated with decreased survival. Overall survivals in patients with elevated levels of IL-6, IL-10, and TNF-α were 53.7%, 56.6%, 53.6%, respectively, compared with 85.7%, 82.5% and 83.6%, respectively, in those with lower levels. Patients with increased levels of both IL-6 and TNF-α had a nearly 6-fold increase in mortality (hazard ratio, 5.82) compared with patients with lower levels.
LIMITATIONS
CONCLUSIONS
Retrospective design, limited sample size, and high-risk population.
CONCLUSIONS
CONCLUSIONS
Hospitalized patients with cancer with rash and elevated IL-6 and TNF-α were nearly 6 times more likely to die over the course of follow-up. These biomarkers may serve as prognostic biomarkers and therapeutic targets for this high-risk population.
Identifiants
pubmed: 32171811
pii: S0190-9622(20)30387-X
doi: 10.1016/j.jaad.2020.03.010
pmc: PMC7486231
mid: NIHMS1575180
pii:
doi:
Substances chimiques
Antineoplastic Agents
0
Biomarkers, Tumor
0
IL10 protein, human
0
IL6 protein, human
0
Interleukin-6
0
TNF protein, human
0
Tumor Necrosis Factor-alpha
0
Interleukin-10
130068-27-8
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
273-282Subventions
Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Informations de copyright
Copyright © 2020 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.
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