Abstract
This study was undertaken to establish the role of cytokines (IL-1, IL-2, IL-4, IL-6, and TNF) in the pathogenesis and the clinical course of childhood ALL. A total of 150 children with ALL (88 boys and 62 girls, aged from 0.5 to 15 years) were included in the study. TNF production was studied in supernatants deriving from 24-h PBSC mononuclear culture using the method based on growth inhibition of mice fibroblasts sensitive to TNF α 929, IL-1 production using a method based on inhibition of autologous rosette formation by CBA mouse thymocytes, and IL-2, IL-4, and IL-6 production using a conventional ELISA Genzyme test. Thirty-nine healthy children served as the control group. TNF and IL-1 production decreased after starting chemotherapy for ALL, while a relative increase of IL-6 was observed. It was found that, in children with ALL, IL-1 production, was significantly lower during the whole of therapy than that observed in the control group of healthy children (p = 0.005). No IL-2 and IL-4 production was observed in children with ALL during the 2.5-year period of observation. After cessation of therapy IL-1 and TNF production rose, while IL-6 production remained on the same level. During the 10-year period after the end of therapy IL-1 median values did not reach the values of the control group. EFS at 73 months in ALL children with IL-1 production <10 units before therapy was better than that observed in children with production >10 units (90.48% v 76.19%; p = 0.005). EFS at 65 months in ALL children with no detectable TNF production before therapy was better than that observed in children with detectable TNF production (92.31% v 72.73%; n.s.). EFS at 55 months in ALL children with IL-4 production >400 pg/ml before therapy was better than that observed in children with production <400 pg/ml (80% v 64.26%; n.s.). IL-1, IL-4, and TNF production could be useful prognostic factors.KeywordsTumor Necrosis FactorAcute Lymphoblastic LeukemiaAcute LeukemiaTumor Necrosis Factor ProductionHuman Myeloma Cell LineThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
Published Version
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