Inflammatory biomarkers predict well-being in elderly patients with AML

Inflammatory biomarkers, such as interleukin-6 (IL-6), IL-6 soluble receptor (sR), C-reactive protein (CRP) and tumour necrosis factor alpha (TNFα), appear to correlate with physical and mental health in elderly patients with acute myeloid leukaemia (AML), a recent study has shown.

The study included 20 elderly AML patients (median age, 68.3 years; 55 percent female) who underwent Geriatric Assessment (GA) at baseline and at 4 weeks after discharge. Blood samples were drawn and subjected to cytokine assays for the measurement of inflammatory biomarker. Outcomes included changes in GA and in biomarker levels, complete remission, and overall survival.

Higher distress at baseline was correlated with elevated TNFα sR1 (p=0.04) and CRP (p=0.04) levels. No other biomarker had such significance at baseline.

Over the duration of follow-up, increasing blood concentrations of TNFα sR1 was associated with self-reported limitations in instrumental activities of daily living (p<0.01) and worsening physical function (p<0.01), as objectively measured by the short physical performance battery (SPPB). Spikes in CRP were likewise inversely correlated with SPPB (p<0.01).

IL-6 sR, on the other hand, was directly correlated with improvements in depressive symptoms (p=0.02).

In terms of AML outcomes, high TNFα was linked to significantly shorter median survival (p=0.04), as was high baseline CRP (p=0.04). No other biomarker correlated with survival.

“The role of TNFα and CRP as biomarkers to predict survival in older patients with AML receiving induction chemotherapy should be confirmed in larger studies,” the researchers said.