Longitudinal assessment of IL-6 and symptom severity in multiple myeloma patients during first 30 days of autologous BMT

Abstract

2616 Background: Patients with multiple myeloma (MM) who undergo auto-BMT develop numerous symptoms, including pain, fatigue, poor appetite, and disturbed sleep, at the nadir of transplantation. IL-6 plays a role in disease progression in MM. This pilot study prospectively assessed the relationship between changes in IL-6 and the severity of symptoms during the acute phase of auto-BMT. Methods: The M. D. Anderson Symptom Inventory (MDASI) was used to assess symptoms in 18 patients before and during the first 30 days post-transplantation. IL-6 was assayed pre-transplantation, at nadir, and at 30 days post-BMT. Results: Serum levels of IL-6 in MM patients were elevated before the BMT compared to non-cancer normal controls. IL-6 levels approximately tripled at nadir and returned almost to baseline level at 30 days. Symptom severity showed a similar increase, almost tripling at nadir and returning to near baseline by day 30. Conclusions: There appears to be a relationship between increased symptom severity and increased IL-6 levels during the acute phase of auto-BMT. The question of a causal link between cytokine levels and symptom severity requires further study and would be helped by more frequent assessment of IL-6 and other inflammatory cytokines. No significant financial relationships to disclose.