Evaluation of Interleukin-6 Level Before Chemotherapy in Acute Lymphoblastic Leukemia L1 Standard-Risk and High-risk Patients

Nadirah Rasyid Ridha; Gabriela Angel Mustakim; Idham Jaya Ganda

doi:10.3889/oamjms.2022.9417

Authors

Nadirah Rasyid Ridha Department of Pediatrics, Faculty of Medicine, Hasanuddin University, Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia https://orcid.org/0000-0002-9636-0953
Gabriela Angel Mustakim Department of Pediatrics, Faculty of Medicine, Hasanuddin University, Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia
Idham Jaya Ganda Department of Pediatrics, Faculty of Medicine, Hasanuddin University, Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2022.9417

Keywords:

Interleukin-6, Acute lymphoblastic leukemia, Cytokine

Abstract

BACKGROUND: Acute lymphoblastic leukemia (ALL) is a malignancy originating from the clonal expansion of lymphoid progenitors that have undergone neoplastic transformation at various stages of differentiation. Interleukin-6 (IL-6) is a pleiotropic inflammatory cytokine produced by various cell types, including T-cells, macrophages, and stromal cells in response to tumor necrosis factor-alpha and interleukin-1.

AIM: This study aims to evaluate serum levels of IL-6 before chemotherapy in standard-risk (SR) and high-risk (HR) ALL patients.

METHODS: The research method was a cross-sectional study conducted on ALL patients who were treated at Dr. Wahidin Sudirohusodo hospital from April 2021 to June 2021. A total of 60 ALL patients were included in the study. Serum IL-6 specimens were examined before the patient received chemotherapy.

RESULTS: The results showed that from 60 samples of ALL patients, 30 were SR and 30 were HR. Elevated levels of IL-6 before chemotherapy were found in both SR and HR ALL but were significantly higher in the HR group compared to the SR group with p value = 0.022. The cutoff point of 64.23 ng/mL for HRALL patients was obtained through ROC with a sensitivity of 63.3%, specificity of 63.3%, a positive predictive value of 63.3%, and a negative predictive value of 63.3%. Adjusted odds ratio are 2,983 with 95% confidence interval of 1.044–8.527.

CONCLUSION: IL-6 levels among HR ALL were higher than SR. Elevated levels of IL-6 were found in both SR and HR ALL.

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References

Sudarmanto B, Abdulsalam M. Kegawatdaruratan onkologi anak. In: Buku Ajar Hematol Onkol Anak. Jakarta: Badan Penerbit Ikatan Dokter Anak Indonesia; 2018. p. 377-80.

Farsani MA, Kamel M, Mehrpouri M, Heris RS, Hamidpour M, Salari S, et al. The expression of interferon gamma (IFN-γ) and interleukin 6 (IL6) in patients with acute lymphoblastic leukemia (ALL). Pathol Oncol Res. 2020;26(1):461-6. https://doi.org/10.1007/s12253-018-0536-z PMid:30443842 DOI: https://doi.org/10.1007/s12253-018-0536-z

Pérez-Figueroa E, Sánchez-Cuaxospa M, Martínez-Soto KA, Sánchez-Zauco N, Medina-Sansón A, Jiménez-Hernández E, et al. Strong inflammatory response and Th1-polarization profile in children with acute lymphoblastic leukemia without apparent infection. Oncol Rep. 2016;35(5):2699-706. https://doi.org/10.3892/or.2016.4657 PMid:26985678 DOI: https://doi.org/10.3892/or.2016.4657

Hernandez C, Huebener P, Schwabe RF. Damage-associated molecular patterns in cancer: A double-edged sword. Oncogene. 2016;35(46):5931-41. https://doi.org/10.1038/onc.2016.104 PMid:27086930 DOI: https://doi.org/10.1038/onc.2016.104

Burger R. Impact of Interleukin-6 in hematological malignancies. Transfus Med Hemother. 2013;40(5):336-43. https://doi.org/10.1159/000354194 PMid:24273487 DOI: https://doi.org/10.1159/000354194

Barrington-Trimis JL, Cockburn M, Metayer C, Gauderman WJ, Wiemels J, McKean-Cowdin R. Trends in childhood leukemia incidence over two decades from 1992 to 2013. Int J Cancer. 2017;140(5):1000-8. DOI: https://doi.org/10.1002/ijc.30487

Miranda-Filho A, Piñeros M, Ferlay J, Soerjomataram I, Monnereau A, Bray F. Epidemiological patterns of leukaemia in 184 countries: A population-based study. Lancet Haematol. 2018;5(1):e14-24. https://doi.org/10.1016/S2352-3026(17)30232-6 PMid:29304322 DOI: https://doi.org/10.1016/S2352-3026(17)30232-6

Woo JS, Alberti MO, Tirado CA. Childhood B-acute lymphoblastic leukemia: A genetic update. Exp Hematol Oncol. 2014;3(1):16. https://doi.org/10.1186/2162-3619-3-16 PMid:24949228 DOI: https://doi.org/10.1186/2162-3619-3-16

O’Brien MM, Seif AE, Hunger SP. Acute lymphoblastic leukemia in children. In: Wintrobe’s C linical Hematology. 14th ed. Netherlands: Wolters Kluwer; 2018. p. 4939-5015.

Kakaje A, Alhalabi MM, Ghareeb A, Karam B, Mansour B, Zahra B, et al. Rates and trends of childhood acute lymphoblastic leukaemia: An epidemiology study. Sci Rep. 2020;10(1):6756. https://doi.org/10.1038/s41598-020-63528-0 PMid:32317670 DOI: https://doi.org/10.1038/s41598-020-63528-0

Dorak MT, Karpuzoglu E. Gender differences in cancer susceptibility: An inadequately addressed issue. Front Genet. 2012;3:268. https://doi.org/10.3389/fgene.2012.00268 PMid:23226157 DOI: https://doi.org/10.3389/fgene.2012.00268

Medina-Sanson A, Ramírez-Pacheco A, Moreno-Guerrero SS, Dorantes-Acosta EM, Sánchez-Preza M, Reyes-López A. Role of genetic polymorphisms of deoxycytidine kinase and cytidine deaminase to predict risk of death in children with acute myeloid leukemia. Biomed Res Int. 2015;2015:309491. https://doi.org/10.1155/2015/309491 PMid:26090398 DOI: https://doi.org/10.1155/2015/309491

Luo YP, Huang ZG, Qian HJ. Tumor necrosis factor and interleukin 6 in acute leukemia. Zhonghua Nei Ke Za Zhi. 1993;32(2):85-7. PMid:8404330

Zhao H, Zhou H, Cao Q, Wang C, Bai J, Lv P, et al. Effect of allogeneic blood transfusion on levels of il-6 and sIL-R2 in peripheral blood of children with acute lymphocytic leukemia. Oncol Lett. 2018;16(1):849-52. https://doi.org/10.3892/ol.2018.8760 PMid:29963154 DOI: https://doi.org/10.3892/ol.2018.8760

Frey NV, Porter DL. Cytokine release syndrome with novel therapeutics for acute lymphoblastic leukemia. Hematology Am Soc Hematol Educ Program. 2016;2016(1):567-72. https://doi.org/10.1182/asheducation-2016.1.567 PMid:27913530 DOI: https://doi.org/10.1182/asheducation-2016.1.567

Xu XJ, Luo ZB, Xia T, Song H, Yang SL, Xu WQ, et al. Comparison of interleukin-6, interleukin-10, procalcitonin and C-reactive protein in identifying high-risk febrile illness in pediatric cancer patients: A prospective observational study. Cytokine. 2019;116:1-6. https://doi.org/10.1016/j.cyto.2019.01.004 PMid:30684912 DOI: https://doi.org/10.1016/j.cyto.2019.01.004

Ramanathan K, Antognini D, Combes A, Paden M, Zakhary B, Ogino M, et al. Since January 2020 Elsevier has Created a COVID-19 Resource Centre with Free Information in English and Mandarin on the Novel Coronavirus COVID-Research that is Available on the COVID-19 Resource Centre-Including this for Unrestricted Research Reuse. Netherlands: Elsevier; 2020. p. 19-21.