Predictive value of proinflammatory activation in prognosis of cardiovascular events after treatment of chronic lymphoid leukemia
DOI:
https://doi.org/10.14739/2310-1210.2017.3.100614Keywords:
interleukin-6, CD40-ligand, chronic lymphoid leukemia, inflammation, prognosisAbstract
Aim: To evaluate the prognostic value of circulating interleukin-6 and CD40 ligand in patients after chronic lymphoid leukemia treatment.
Materials and Methods: 193 patients with chronic lymphoid leukemia after chemotherapy were included in the study. Observation period was up to 12 months. Blood plasma samples were taken for circulating levels of interleukin-6 and CD40 ligand measurements with the help of ELISA method.
Results: During observation period, 29 patients had progression of chronic lymphoid leukemia. 8 patients were excluded from the study due to their absence on the regular visit. Therefore, further analysis included 156 patients. 216 clinical events were recorded in 51 patients (32.7 %) with the following distribution: 122 cardiac arrhythmias, 16 cardiac ischemic events, 3 strokes, 30 chronic heart failures and 38 hospital admissions for cardiovascular reasons, 7 cardiovascular deaths, and 18 noncardiovascular deaths. Medians of interleukin-6 circulating levels in free-events subject cohort and subjects cohort with cardiovascular events were 0.78 ng/ml (95 % confidence interval [CI] = 0.61–1.86 ng/ml) and 1.50 ng/ml (95 % CI = 0.56–5.84 ng/ml) (p = 0.026) respectively. Medians of CD40 ligand circulating levels in free-events subject cohort and subjects cohort with cardiovascular events were 1.24 ng/ml (95 % CI = 0.76–3.20 ng/ml) and 2.88 ng/ml (95 % CI = 1.83–6.36 ng/ml) (p = 0.076) respectively. Interleukin-6 positively correlated with CD40 ligand (r = 0.33, p = 0.04).
The patients with elevated levels of both interleukin-6 and CD40 ligand had increased risk of cardiovascular events, whereas CD40 ligand, T2DM, hypertension, obesity, LVEF, and multi-vessel lesion did not.
Conclusions: Among patients who have been previously treated for chronic lymphoid leukemia, increased circulating interleukin-6 and CD40 ligand associated with increased cumulative cardiovascular events. Serum levels of interleukin-6 and CD40 ligand could be useful to predict the long-term outcome in patients with chronic lymphoid leukemia.
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