H. Alejandro Preti, MD; Fernando Cabanillas, MD; Moshe Talpaz, MD; Susan L. Tucker, PhD; John F. Seymour, MB, BS; Razelle Kurzrock, MD
Preti HA, Cabanillas F, Talpaz M, Tucker SL, Seymour JF, Kurzrock R. Prognostic Value of Serum Interleukin-6 in Diffuse Large-cell Lymphoma. Ann Intern Med. 1997;127:186-194. doi: 10.7326/0003-4819-127-3-199708010-00002
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Published: Ann Intern Med. 1997;127(3):186-194.
Interleukin-6 has important lymphoid bioregulatory effects, and serum levels of interleukin-6 are often elevated in patients with lymphoma.
To determine the relation between serum levels of interleukin-6 before treatment and outcome in patients with diffuse large-cell lymphoma.
Retrospective cohort analysis with multivariate analysis.
Tertiary referral center.
118 untreated patients with diffuse large-cell lymphoma who were enrolled in frontline chemotherapy protocols and 45 healthy controls.
Serum levels of interleukin-6 were measured by using a sensitive enzyme-linked immunosorbent assay. Levels below the upper limit of the range for controls were considered normal. Outcomes were complete response, failure-free survival, and overall survival.
Serum levels of interleukin-6 were higher in patients with lymphoma (median, 4.6 pg/mL [range, undetectable to 224 pg/mL]) than in controls (median, undetectable [range, undetectable to 4.3 pg/mL]) (P = 0.009). The complete response rate was 95% for persons with normal interleukin-6 levels and 66% for persons with high interleukin-6 levels (P = 0.001). Patients with high interleukin-6 levels had inferior failure-free and overall survival rates (P < 0.001 for both comparisons). The actuarial 4-year failure-free and overall survival rates were 72% and 85%, respectively, for persons with normal interleukin-6 levels and 37% and 46%, respectively, for persons with high interleukin-6 levels. In multivariate analysis, interleukin-6 was selected as the most significant predictor of complete response and failure-free survival. Failure-free and overall survival of patients stratified according to International Prognostic Index score could be further stratified by interleukin-6 level (P ≤ 0.03 for all comparisons).
In patients with diffuse large-cell lymphoma, serum interleukin-6 levels are an independent prognostic factor for complete response and failure-free survival.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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