IL-6, TNF-α up mortality risk in hospitalized cancer patients with rash

Hospitalized cancer patients with rash and elevated interleukin (IL)-6 and tumour necrosis factor (TNF)-α have a sixfold increased risk of mortality over the course of follow-up, according to a recent study.

“These biomarkers may serve as prognostic biomarkers and therapeutic targets for this high-risk population,” the authors said.

This retrospective review included 144 hospitalized patients with cancer with a morbilliform rash, recorded testing for serum cytokines (IL-6, IL-10, and TNF-α) or elafin, and a dermatology consultation. Rashes were categorized as either simple morbilliform rash without systemic involvement or complex morbilliform rash with systemic involvement.

Of the patients, 54 (37.5 percent) died during follow-up. Elevated levels of IL-6, IL-10, and TNF-α were predictive of poorer survival. Overall survival rates in patients with elevated of IL-6, IL-10, and TNF-α were 53.7 percent, 56.6 percent, and 53.6 percent, respectively, compared with 85.7 percent, 82.5 percent, and 83.6 percent, respectively, in those with lower levels.

Of note, patients with higher levels of both IL-6 and TNF-α were nearly six times more likely to die (hazard ratio, 5.82) than those with lower levels.

This study was limited by its retrospective design, small sample size, and high-risk population, according to the authors.

“Severe cutaneous adverse reactions (SCARs) are associated with high morbidity and mortality in patients with cancer. Early identification and treatment of SCARs may improve outcomes,” they noted.