Background

Severe cutaneous adverse reactions (SCARs) are associated with high morbidity and mortality in patients with cancer. Early identification and treatment of SCARs may improve outcomes.

Objective

To identify biomarkers to predict outcomes in hospitalized patients with cancer who developed SCARs.

Methods

Retrospective review of 144 hospitalized patients with cancer with a morbilliform rash, recorded testing for serum cytokines (interleukin [IL]-6, IL-10, and tumor necrosis factor [TNF]-α) or elafin, and a dermatology consultation. Rashes were categorized as simple morbilliform rash without systemic involvement or complex morbilliform rash with systemic involvement.

Results

Fifty-four of 144 (37.5%) patients died during follow-up. Elevated levels of IL-6, IL-10, and TNF-α were associated with decreased survival. Overall survivals in patients with elevated levels of IL-6, IL-10, and TNF-α were 53.7%, 56.6%, 53.6%, respectively, compared with 85.7%, 82.5% and 83.6%, respectively, in those with lower levels. Patients with increased levels of both IL-6 and TNF-α had a nearly 6-fold increase in mortality (hazard ratio, 5.82) compared with patients with lower levels.

Limitations

Retrospective design, limited sample size, and high-risk population.

Conclusions

Hospitalized patients with cancer with rash and elevated IL-6 and TNF-α were nearly 6 times more likely to die over the course of follow-up. These biomarkers may serve as prognostic biomarkers and therapeutic targets for this high-risk population.

中文翻译：

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白细胞介素-6和肿瘤坏死因子-α与住院癌症患者死亡率的关系。

背景

严重皮肤不良反应 (SCAR) 与癌症患者的高发病率和死亡率相关。SCAR 的早期识别和治疗可能会改善预后。

客观的

确定生物标志物以预测发生 SCAR 的住院癌症患者的预后。

方法

回顾性回顾了 144 例因麻疹样皮疹住院的癌症患者，记录了血清细胞因子（白细胞介素 [IL]-6、IL-10 和肿瘤坏死因子 [TNF]-α）或弹性蛋白的检测，以及皮肤科会诊。皮疹分为无全身受累的单纯麻疹样皮疹或全身受累的复杂麻疹样皮疹。

结果

144 名患者中有 54 名（37.5%）在随访期间死亡。IL-6、IL-10 和 TNF-α 水平升高与存活率降低有关。IL-6、IL-10 和 TNF-α 水平升高的患者的总生存率分别为 53.7%、56.6%、53.6%，而水平较低的患者的总生存率分别为 85.7%、82.5% 和 83.6% . 与水平较低的患者相比，IL-6 和 TNF-α 水平升高的患者死亡率增加近 6 倍（风险比，5.82）。

限制

回顾性设计、有限的样本量和高危人群。

结论

在随访过程中，因皮疹和 IL-6 和 TNF-α 升高而住院的癌症患者死亡的可能性增加了近 6 倍。这些生物标志物可作为这一高危人群的预后生物标志物和治疗靶点。