Plasma cytokine and P-selectin levels in advanced malignancy - Prognostic value and impact of low-molecular weight heparin administration

被引:12
作者
Di Nisio, M
Niers, TM
Reitsma, PH
Buller, HR
机构
[1] Univ Amsterdam, Acad Med Ctr, Dept Vasc Med, NL-1100 DD Amsterdam, Netherlands
[2] Univ Fdn, CeSI GD Annunzio, Dept Internal Med, Aging Res Ctr, Pescara, Italy
[3] Univ Amsterdam, Acad Med Ctr, Lab Expt Internal Med, NL-1100 DD Amsterdam, Netherlands
关键词
cytokines; innate immunity; prognosis; low molecular weight heparin;
D O I
10.1002/cncr.21485
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BACKGROUND. The survival benefit described in patients with cancer treated with low molecular weight heparin (LMWH) may result from a LMWH-mediated effect on the immune system or oil the cross-talk between platelets and tumor cells. METHODS. Plasma levels of interleukin (IL)-10, IL-6, interferon (IFN)-gamma, and P-selectin were measured in patients with advanced stage malignancy who were randomized to receive standard cancer care with or without the addition of LMWH. RESULTS. Patients with IL-6 levels above the median had a median survival of 6.5 months versus 8.8 months for those with values below this cutoff (P = 0.02), IL-10 levels were found to be similarly correlated with survival such that IL-10 concentrations above the detection limit of the assay were associated with a doubled risk of dying in comparison to undetectable IL-10 (P = 0.02). No significant association was found between survival and circulating levels of IFN-gamma. For P-selectin, patients with values below the fourth quartile had a median survival of 8.8 months versus 6.5 months for patients with levels above the fourth quartile (P = 0.02). In multivariate analysis, IL-10 remained an independent unfavorable prognostic factor (hazard ratio, 2.13; 95% confidence interval, 1.08-4.20). In patients treated with LMWH, the plasma levels of IL-6, IL-10, IFN-gamma, and P-selectin demonstrated similar correlations with Survival. However, none of the markets was associated with the beneficial survival effects observed with the administration of LMWH. CONCLUSIONS. IL-10, IL-6, and P-selectin levels predicted a poor Outcome ill patients with advanced stage malignancy. The prolongation in survival observed with LMWH in patients with cancer apparently cannot be explained by a LMWH effect on these circulating markers.
引用
收藏
页码:2275 / 2281
页数:7
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