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A new cytokine-based dynamic stratification during induction is highly predictive of survivals in acute myeloid leukemia.

ABSTRACT: The aim of this study was to assess the potential impact of the kinetics of serum levels of seven cytokines during induction in acute myeloid leukemia (AML) patients. Indeed, the role of cytokines, in the pathophysiology and response to therapy of AML patients, remains under investigation. Here, we report on the impact of peripheral levels of two cytokines, the Fms-like tyrosine kinase 3 ligand (FL) and interleukin-6 (IL-6), evaluated during first-line intensive induction. A new risk stratification can be proposed, which supersedes the ELN 2017 classification to predict survivals in AML patients by examining the kinetic profile of these cytokines during the induction phase. It segregates three groups of, respectively, high-risk, characterized by a stagnation of low FL levels, intermediate risk, with dynamic increasing FL levels and high IL-6 at day 22, and favorable risk with increasing FL levels but low IL-6 at day 22.

SUBMITTER: Peterlin P

PROVIDER: S-EPMC7877358 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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A new cytokine-based dynamic stratification during induction is highly predictive of survivals in acute myeloid leukemia.

Peterlin Pierre P Gaschet Joelle J Guillaume Thierry T Garnier Alice A Eveillard Marion M Le Bourgeois Amandine A Cherel Michel M Debord Camille C Le Bris Yannick Y Theisen Olivier O Godon Catherine C Mahé Béatrice B Dubruille Viviane V Wuilleme Soraya S Touzeau Cyrille C Gastinne Thomas T Blin Nicolas N Lok Anne A Tessoulin Benoît B Le Gouill Steven S Moreau Philippe P Béné Marie-C MC Chevallier Patrice P

Cancer medicine 20201225 2

The aim of this study was to assess the potential impact of the kinetics of serum levels of seven cytokines during induction in acute myeloid leukemia (AML) patients. Indeed, the role of cytokines, in the pathophysiology and response to therapy of AML patients, remains under investigation. Here, we report on the impact of peripheral levels of two cytokines, the Fms-like tyrosine kinase 3 ligand (FL) and interleukin-6 (IL-6), evaluated during first-line intensive induction. A new risk stratificat ...[more]

PMID: 33369136

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Project description:BackgroundThe majority of studies that provide insights into the influence of the microbiome on the health of hematologic malignancy patients have concentrated on the transplant setting. Here, we sought to assess the predictive capacity of the gastrointestinal microbiome and its relationship to infectious outcomes in patients with acute myeloid leukemia (AML).Methods16s rRNA-based analysis was performed on oral swabs and stool samples obtained biweekly from baseline until neutrophil recovery following induction chemotherapy (IC) in 97 AML patients. Microbiome characteristics were correlated with clinical outcomes both during and after IC completion.ResultsAt the start of IC, higher stool Shannon diversity (hazard ratio [HR], 0.36; 95% confidence interval [CI], .18-.74) and higher relative abundance of Porphyromonadaceae (HR, 0.36; 95% CI, .18-.73) were associated with increased probability of remaining infection-free during neutropenia. A baseline stool Shannon diversity cutoff of <2 had optimal operating characteristics for predicting infectious complications during neutropenia. Although 56 patients received therapy >72 hours with a carbapenem, none of the patients had an infection with an extended spectrum β-lactamase-producing organism. Patients who received carbapenems for >72 hours had significantly lower α-diversity at neutrophil recovery (P = .001) and were approximately 4 times more likely to have infection in the 90 days following neutrophil recovery (HR, 4.55; 95% CI, 1.73-11.93).ConclusionsOur results suggest that gut microbiome evaluation could assist with infectious risk stratification and that improved targeting of antibiotic administration during IC could decrease subsequent infectious complications in AML patients.Baseline microbiome diversity is a strong independent predictor of infection during acute myeloid leukemia induction chemotherapy (IC) among clinical and microbiome covariates. Higher baseline levels of Porphyromonadaceae appear protective against infection, while carbapenem use is associated with consequences to the microbiome and infection susceptibility post-IC.

Dataset Information

A new cytokine-based dynamic stratification during induction is highly predictive of survivals in acute myeloid leukemia.

Publications

A new cytokine-based dynamic stratification during induction is highly predictive of survivals in acute myeloid leukemia.

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