INVESTIGATION OF STRESS AND INFLAMMATORY MARKERS IN ACUTE LEUKEMIA BEFORE AND AFTER CHEMOTHERAPY
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Inflammation, Stress, Chemotherapy, Acute lymphoblastic leukemia, Acute myeloid leukemia
Abstract
Chemotherapy affects biomarkers linked to inflammation and stress and is essential in the treatment of acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). This study compared the levels of cortisol, tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and C-reactive protein (CRP) in patients with AML and ALL before and after chemotherapy. This study includes 20 AML patients and 14 ALL individuals. To evaluate the levels of TNF-α, IL-6, cortisol, and CRP, blood samples were taken both before and after chemotherapy. Standard error of the mean (SEM) and paired t-test were used to statistically assess the data. A significance level of P < 0.05 was established. The findings showed that CRP levels significantly decreased in both AML (P = 0.010) and ALL (P = 0.004), suggesting a reduction in systemic inflammation. In ALL (P = 0.008) and AML (P < 0.001), cortisol levels also considerably decreased, indicating a decrease in physiological stress. Both leukemia types exhibited significant reductions in pro-inflammatory cytokines TNF-α and IL-6 (P < 0.05), indicating the importance of treatment in reducing inflammatory responses. These results demonstrate how well chemotherapy effectively reduces inflammatory and stress biomarkers in acute leukemia patients, demonstrating its anti-inflammatory and stress-reducing benefits.
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References
Anand, U., Dey, A., Chandel, A. K. S., Sanyal, R., Mishra, A., Pandey, D. K., De Falco, V., Upadhyay, A., Kandimalla, R., Chaudhary, A., Dhanjal, J. K., Dewanjee, S., Vallamkondu, J., & Pérez de la Lastra, J. M. (2023). Cancer chemotherapy and beyond: Current status, drug candidates, associated risks and progress in targeted therapeutics. Genes & Diseases, 10(4), 1367–1401. https://doi.org/10.1016/j.gendis.2022.02.007
Baldo, B. A. (2016). Monoclonal Antibodies Approved for Cancer Therapy. In Safety of Biologics Therapy (pp. 57–140). Springer International Publishing. https://doi.org/10.1007/978-3-319-30472-4_3
Bruserud, Ø., Aarstad, H. H., & Tvedt, T. H. A. (2020). Combined C-Reactive Protein and Novel Inflammatory Parameters as a Predictor in Cancer—What Can We Learn from the Hematological Experience? Cancers, 12(7), 1966. https://doi.org/10.3390/cancers12071966
Burnett, A., Wetzler, M., & Löwenberg, B. (2011). Therapeutic Advances in Acute Myeloid Leukemia. Journal of Clinical Oncology, 29(5), 487–494. https://doi.org/10.1200/JCO.2010.30.1820
Burocziova, M., Grusanovic, S., Vanickova, K., Kosanovic, S., & Alberich-Jorda, M. (2023). Chronic inflammation promotes cancer progression as a second hit. Experimental Hematology, 128, 30–37. https://doi.org/10.1016/j.exphem.2023.09.002
Cash, E., Beck, I., Harbison, B., Albert, C., & Sephton, S. E. (2024). Evening cortisol levels are prognostic for progression-free survival in a prospective pilot study of head and neck cancer patients. Frontiers in Oncology, 14. https://doi.org/10.3389/fonc.2024.1436996
Flaherty, R. L., Falcinelli, M., & Flint, M. S. (2019). Stress and drug resistance in cancer. Cancer Drug Resistance. https://doi.org/10.20517/cdr.2019.016
Giordano, P., Molinari, A. C., Del Vecchio, G. C., Saracco, P., Russo, G., Altomare, M., Perutelli, P., Crescenzio, N., Santoro, N., Marchetti, M., De Mattia, D., & Falanga, A. (2010). Prospective study of hemostatic alterations in children with acute lymphoblastic leukemia. American Journal of Hematology, 85(5), 325–330. https://doi.org/10.1002/ajh.21665
Hu, T., Liu, C.-H., Lei, M., Zeng, Q., Li, L., Tang, H., & Zhang, N. (2024). Metabolic regulation of the immune system in health and diseases: mechanisms and interventions. Signal Transduction and Targeted Therapy, 9(1), 268. https://doi.org/10.1038/s41392-024-01954-6
Iivanainen, S., Ahvonen, J., Knuuttila, A., Tiainen, S., & Koivunen, J. P. (2019). Elevated CRP levels indicate poor progression-free and overall survival on cancer patients treated with PD-1 inhibitors. ESMO Open, 4(4). https://doi.org/10.1136/esmoopen-2019-000531
Jayachandran, D., Rundell, A. E., Hannemann, R. E., Vik, T. A., & Ramkrishna, D. (2014). Optimal chemotherapy for Leukemia: A model-based strategy for individualized treatment. PLoS ONE, 9(10). https://doi.org/10.1371/journal.pone.0109623
Kareva, I. (2017). A Combination of Immune Checkpoint Inhibition with Metronomic Chemotherapy as a Way of Targeting Therapy-Resistant Cancer Cells. International Journal of Molecular Sciences, 18(10), 2134. https://doi.org/10.3390/ijms18102134
Ke, W., Zhang, L., & Dai, Y. (2020). The role of IL-6 in immunotherapy of non-small cell lung cancer (NSCLC) with immune-related adverse events (irAEs). In Thoracic Cancer (Vol. 11, Issue 4, pp. 835–839). John Wiley and Sons Inc. https://doi.org/10.1111/1759-7714.13341
Khan, M., Siddiqi, R., & Naqvi, K. (2018). An update on classification, genetics, and clinical approach to mixed phenotype acute leukemia (MPAL). Annals of Hematology, 97(6), 945–953. https://doi.org/10.1007/s00277-018-3297-6
Krsek, A., Ostojic, L., Zivalj, D., & Baticic, L. (2024). Navigating the Neuroimmunomodulation Frontier: Pioneering Approaches and Promising Horizons—A Comprehensive Review. International Journal of Molecular Sciences, 25(17), 9695. https://doi.org/10.3390/ijms25179695
Lucas, F., & Hergott, C. B. (2023). Advances in Acute Myeloid Leukemia Classification, Prognostication and Monitoring by Flow Cytometry. Clinics in Laboratory Medicine, 43(3), 377–398. https://doi.org/10.1016/j.cll.2023.04.005
Morrow, G. R., Hickok, J. T., Andrews, P. L. R., & Stern, R. M. (2002). Reduction in serum cortisol after platinum based chemotherapy for cancer: a role for the HPA axis in treatment-related nausea? Psychophysiology, 39(4), 491–495.
Mrózek, K., Heerema, N. A., & Bloomfield, C. D. (2004). Cytogenetics in acute leukemia. Blood Reviews, 18(2), 115–136. https://doi.org/https://doi.org/10.1016/S0268-960X(03)00040-7
Mukherjee, O., Rakshit, S., Shanmugam, G., & Sarkar, K. (2023). Role of chemotherapeutic drugs in immunomodulation of cancer. Current Research in Immunology, 4, 100068. https://doi.org/10.1016/j.crimmu.2023.100068
Park, H. S. (2024). What is new in acute myeloid leukemia classification? In Blood Research (Vol. 59, Issue 1). Springer. https://doi.org/10.1007/s44313-024-00016-8
Saadi, M. I., Ramzi, M., Hosseinzadeh, M., Ebrahimi, N., Owjfard, M., Abdolyousefi, E. N., Hesami, Z., Valibeigi, B., Zareei, N., Tavasolian, F., Haghighinejad, H., & Zare, A. (2021). Expression Levels of Il-6 and Il-18 in Acute Myeloid Leukemia and Its Relation with Response to Therapy and Acute GvHD After Bone Marrow Transplantation. Indian Journal of Surgical Oncology, 12(3), 465–471. https://doi.org/10.1007/s13193-021-01358-w
Shimony, S., Stahl, M., & Stone, R. M. (2023). Acute myeloid leukemia: 2023 update on diagnosis, risk-stratification, and management. American Journal of Hematology, 98(3), 502–526. https://doi.org/10.1002/ajh.26822
Sproston, N. R., & Ashworth, J. J. (2018). Role of C-Reactive Protein at Sites of Inflammation and Infection. Frontiers in Immunology, 9. https://doi.org/10.3389/fimmu.2018.00754
Templeton, A. J., McNamara, M. G., Šeruga, B., Vera-Badillo, F. E., Aneja, P., Ocaña, A., Leibowitz-Amit, R., Sonpavde, G., Knox, J. J., Tran, B., Tannock, I. F., & Amir, E. (2014). Prognostic Role of Neutrophil-to-Lymphocyte Ratio in Solid Tumors: A Systematic Review and Meta-Analysis. JNCI: Journal of the National Cancer Institute, 106(6), dju124. https://doi.org/10.1093/jnci/dju124
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