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Inflammatory biomarkers, geriatric assessment, and treatment outcomes in acute myeloid leukemia.

Abstract：

OBJECTIVES:To investigate changes in inflammatory biomarkers during induction therapy for older adults with acute myeloid leukemia (AML) and their associations with geriatric assessment (GA) measures and outcomes. METHODS:This was a single institution ancillary study to a prospective observational study (N = 20 consecutive adults aged ≥60 with newly diagnosed AML who received induction chemotherapy). Biomarkers (Interleukin-6 [IL-6], IL-6 soluble receptor [IL-6 sR], tumor necrosis factor alpha [TNFα], TNFα soluble receptor 1 [TNFα sR1], interleukin-3 [IL-3], C-reactive protein [CRP]) were collected at start of induction, weekly for three weeks, and post-induction and were compared over time using paired t-tests. GA was administered at baseline and post-induction, and correlated with biomarker levels using Spearman correlations. Survival was estimated using Kaplan-Meier and compared by categorized biomarker level using Wilcoxon tests. RESULTS:Biomarker levels were stable during induction, except for CRP and IL-6 sR. Declines in objectively measured physical function [Short Physical Performance Battery (SPPB); r = 0.71, p < 0.01] and increases in self-reported limitation in instrumental activities of daily living (r = 0.81, p < 0.01) were correlated with increased TNFα sR1. Declines in SPPB were correlated with increased CRP (r = -0.73, p < 0.01). Improvement in depression was correlated with increased IL-6 sR (r = -0.59 p = 0.02). Survival was shorter in those with baseline TNFα or CRP levels above the median (6.1 vs. 40.2 months and 5.5 vs. 27.6 months respectively, p = 0.04 for both). CONCLUSION:Among older adults with AML, the relationships between TNFα sR1, CRP, and IL-6 sR with change in physical and emotional health during treatment warrants further investigation.

journal_name

J Geriatr Oncol

journal_title

Journal of geriatric oncology

authors

Loh KP,Tooze JA,Nicklas BJ,Kritchevsky SB,Williamson JD,Ellis LR,Powell BL,Pardee TS,Goyal NG,Klepin HD

doi

10.1016/j.jgo.2019.03.014

subject

Has Abstract

pub_date

2020-04-01 00:00:00

pages

410-416

issue

eissn

1879-4068

issn

1879-4076

pii

S1879-4068(19)30041-4

journal_volume

pub_type

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Inflammatory biomarkers, geriatric assessment, and treatment outcomes in acute myeloid leukemia.