Plasma level of interleukin-18 and complicated course of febrile neutropenia in hematological patients after intensive chemotherapy

Korpelainen, Sini; Hämäläinen, Sari; Vänskä, Matti; Koivula, Irma; Pulkki, Kari; Jantunen, Esa; Juutilainen, Auni; Purhonen, Anna-Kaisa

doi:10.1016/j.cyto.2020.155021

Cited by 1 publication

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“…In septic patients, serum concentrations of IL-18 were negatively correlated with platelet counts suggesting a role of IL-18 in the development of severe thrombocytopenia during sepsis [ 38 ]. Recently, Korpelainen and colleagues [ 39 ] in their study on hematological patients receiving intensive chemotherapy found an inverse correlation between IL-18 and leukocyte counts and an association with complicated courses of febrile neutropenia in the subgroup of autologous stem cell recipients with lymphoma. Consequently, it is tempting to speculate that IL-18 neutralization may represent a means to enhance hematopoietic engraftment and/or reduce occurrence of cytopenias in patients with elevated IL-18 levels.…”

Section: Discussionmentioning

confidence: 99%

Interleukin-18 and Hematopoietic Recovery after Allogeneic Stem Cell Transplantation

Radujkovic

Kordelas

Bogdanov

et al. 2020

Cancers

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Interleukin-18 (IL-18) is an immunoregulatory cytokine and a context-dependent regulator of hematopoietic stem/progenitor cell (HSPC) quiescence in murine models. In a previous study, high pre-conditioning levels of IL-18 were associated with increased non-relapse mortality (NRM) after allogeneic stem cell transplantation (alloSCT). To investigate the clinical impact of IL-18 status on hematopoietic function, the associations of pre-conditioning and day 0–3 cytokine levels with platelet and neutrophil recovery were analyzed in a training cohort of 714 allografted patients. In adjusted logistic regression analyses, both increasing pre-conditioning and day 0–3 IL-18 levels had a significantly higher adjusted odds ratio (aOR) of delayed platelet and neutrophil recovery on day +28 post-transplant (aOR per two-fold increase: 1.6–2.0). The adverse impact of high pre-conditioning IL-18 on day +28 platelet recovery was verified in an independent cohort of 673 allografted patients (aOR per two-fold increase: 1.8 and 1.7 for total and free IL-18, respectively). In both cohorts, a platelet count ≤20/nL on day +28 was associated with a significantly increased hazard of NRM (hazard ratio 2.13 and 2.94, respectively). Our findings support the hypothesis that elevated peritransplant IL-18 levels affect post-transplant HSPC function and may provide a rationale to explore modulation of IL-18 for improving alloSCT outcomes.

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Section: Discussionmentioning

confidence: 99%