The Relationship between Fatigue and Cytokine Levels in Patients with Acute Myeloid Leukemia
Background: Cancer-related fatigue (CRF) is a very prominent complaint and disabling symptom in cancer patients probably influenced by endogenous cytokines. But, the published data on this subject are limited. We explored the relationship of cytokines such as tumor necrosis factor (TNF-α) and interleukin-6 (IL-6) with fatigue in patients with AML.
Materials and Methods: This study was performed on 45 patients (25 men, 20 women) with newly diagnosed AML. We examined fatigue in these patients with validated questionnaire. Simultaneously, blood samples were obtained for quantitative measurement of IL-6 and TNF-α.
Results: Our results showed a positive correlation between fatigue and circulating levels of IL-6 (P=0.004, R=0.416).
Conclusion: Many patients with AML experienced severe fatigue before the onset of treatment, which is not related to their hemoglobin (Hb) levels. Cytokine levels may be beneficial markers in resistance to fatigue, but further studies are needed before considering targeted therapies as a treatment for CRF.
Sanchez-Correa B, Bergua JM, Campos C, Gayoso I, Arcos MJ, Bañas H, et al. Cytokine profiles in acute myeloid leukemia patients at diagnosis: survival is inversely correlated with IL-6 and directly correlated with IL-10 levels. Cytokine. 2013.61:885-91.
Brocker C, Thompson D, Matsumoto A, Nebert DW, and Vasiliou V. Evolutionary divergence and functions of the human interleukin (IL) gene family. Hum Genomics. 2010.5:30.
Fung FY, Li M, Breunis H, Timilshina N, Minden MD, and Alibhai SM. Correlation between cytokine levels and changes in fatigue and quality of life in patients with acute myeloid leukemia. Leuk Res. 2013.37:274-9.
Minton O, Stone P. A systematic review of the scales used for the measurement of cancer-related fatigue (CRF). Ann Oncol. 2008.20:17-25.
Jean-Pierre P, Figueroa-Moseley CD, Kohli S, Fiscella K, Palesh OG, Morrow GR. Assessment of cancer-related fatigue: implications for clinical diagnosis and treatment. Oncologist. 2007.12:11-21.
Schubert C, Hong S, Natarajan L, Mills PJ, Dimsdale JE. The association between fatigue and inflammatory marker levels in cancer patients: a quantitative review. Brain Behav Immun. 2007.21:413-27.
Alibhai S, Leach M, Kowgier M, Tomlinson G, Brandwein J, Minden M. Fatigue in older adults with acute myeloid leukemia: predictors and associations with quality of life and functional status. Leukemia. 2007.21:845.
Kurzrock R. The role of cytokines in cancer‐related fatigue. Cancer. 2001.92:1684-8.
Yellen SB, Cella DF, Webster K, Blendowski C, Kaplan E. Measuring fatigue and other anemia-related symptoms with the Functional Assessment of Cancer Therapy (FACT) measurement system. J Pain Symptom Manage. 1997.13:63-74.
Schumacher A, Wewers D, Heinecke A, Sauerland C, Koch OM, van de Loo J, et al. Fatigue as an important aspect of quality of life in patients with acute myeloid leukemia. Leuk Res. 2002.26:355-62.
Bower JE. Cancer-related fatigue: links with inflammation in cancer patients and survivors. Brain Behav Immun. 2007.21:863-71.
Meyers CA, Albitar M, Estey E. Cognitive impairment, fatigue, and cytokine levels in patients with acute myelogenous leukemia or myelodysplastic syndrome. Cancer. 2005.104:788-93.
Liu L, Mills PJ, Rissling M, Fiorentino L, Natarajan L, Dimsdale JE, et al. Fatigue and sleep quality are associated with changes in inflammatory markers in breast cancer patients undergoing chemotherapy. Brain Behav Immun. 2012.26:706-13.
Bower JE, Ganz PA, Aziz N, Fahey JL. Fatigue and proinflammatory cytokine activity in breast cancer survivors. Psychosom Med. 2002.64:604-11.
Mills PJ, Parker B, Dimsdale JE, Sadler GR, Ancoli-Israel S. The relationship between fatigue and quality of life and inflammation during anthracycline-based chemotherapy in breast cancer. Biol Psychol. 2005.69:85-96.
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