Interleukin-6 plasma levels are modulated by a polymorphism in the NF-κB1 gene and are associated with outcome following rituximab-combined chemotherapy in diffuse large B-cell non-Hodgkin lymphoma

Leuk Lymphoma. 2012 Mar;53(3):411-6. doi: 10.3109/10428194.2011.621566. Epub 2011 Oct 24.

Abstract

Peripheral blood cytokines are known prognostic parameters in diffuse large B-cell lymphoma (DLBCL) treated with chemotherapy, but their role after the introduction of rituximab is unknown. Seven polymorphisms in the promoter regions of IL-6, IL-10 and NF-κB1 genes were assessed in 167 patients with DLBCL and 99 controls and correlated with interleukin-6 (IL-6) and IL-10 plasma levels. Outcome was analyzed in 137 patients treated with rituximab-based chemotherapy. The NF-κB1 - 94ATTG deletion was associated with increased IL-6 and IL-10 in DLBCL. High IL-6 concentration correlated with unfavorable prognostic factors included in the international prognostic index (IPI) and predicted for inferior progression-free (p = 0.007) and overall survival (p = 0.02). IL-6 levels remained a significant outcome predictor also including IPI as a covariate (p = 0.006 for progression-free survival). Our data suggest that the NF-κB1 genetic background influences IL-6 production in DLBCL, and that high IL-6 concentration is an independent prognostic factor also in the "rituximab era."

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Monoclonal, Murine-Derived / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Carboplatin / administration & dosage
  • Cyclophosphamide / administration & dosage
  • Cytarabine / administration & dosage
  • Doxorubicin / administration & dosage
  • Female
  • Gene Expression Regulation, Neoplastic / genetics
  • Genotype
  • Humans
  • Interleukin-10 / blood*
  • Interleukin-10 / genetics
  • Interleukin-6 / blood*
  • Interleukin-6 / genetics
  • Kaplan-Meier Estimate
  • Lymphoma, Large B-Cell, Diffuse / drug therapy
  • Lymphoma, Large B-Cell, Diffuse / genetics*
  • Lymphoma, Large B-Cell, Diffuse / mortality
  • Male
  • Methylprednisolone / administration & dosage
  • Middle Aged
  • Mitoxantrone / administration & dosage
  • NF-kappa B p50 Subunit / genetics*
  • NF-kappa B p50 Subunit / physiology
  • Neoplasm Proteins / genetics*
  • Neoplasm Proteins / physiology
  • Phenotype
  • Polymorphism, Single Nucleotide*
  • Prednisone / administration & dosage
  • Prognosis
  • Promoter Regions, Genetic / genetics
  • Rituximab
  • Sequence Deletion
  • Treatment Outcome
  • Vincristine / administration & dosage
  • Young Adult

Substances

  • Antibodies, Monoclonal, Murine-Derived
  • IL10 protein, human
  • IL6 protein, human
  • Interleukin-6
  • NF-kappa B p50 Subunit
  • NFKB1 protein, human
  • Neoplasm Proteins
  • Cytarabine
  • Interleukin-10
  • Rituximab
  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • Carboplatin
  • Mitoxantrone
  • Prednisone
  • Methylprednisolone

Supplementary concepts

  • CHOP protocol
  • MiCMA protocol