Associations of inflammation with symptom burden in patients with acute myeloid leukemia
Associations of inflammation with symptom burden in patients with acute myeloid leukemia
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DOI：
10.1016/j.psyneuen.2018.01.018
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发表时间：
2018-03-01
影响因子：
3.7
通讯作者：
Heijnen, Cobi J.
中科院分区：
文献类型：
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作者：
Lacourt, Tamara E.;Kavelaars, Annemieke;Heijnen, Cobi J.
该研究的目的是评估急性髓性白血病（AML）患者炎症与症状负担的关系，在缓解诱导化疗（IC）之前和期间进行评估。从基线（IC前）到IC的第三周，对AML患者（n = 95）进行随访，以评估自我报告的躯体症状的严重程度（用MD安德森症状量表评估）和13种炎症相关生物标志物的血浆水平（n = 64）。综合症状负担严重程度评分计算为6种最严重躯体症状（疲劳、睡眠不安、嗜睡、口干、食欲不振和疼痛）的平均分。横断面分析结果显示，炎症与IC前症状负担的相关性较弱（多元回归模型，解释方差= 10%），但在IC期间这种相关性增强（第3周解释方差= 35%）。大约一半的样本随着时间的推移，症状的严重程度发生了变化。这些变化并没有反映在炎症标志物随时间的类似变化中，这表明，重要的是特定炎症标志物在特定时间点的绝对浓度，而不是其随时间的相对变化。综上所述，炎症仅在IC期间与症状负担密切相关，可能是因为细胞因子的表达仅在这时才与症状负担的调节相关。虽然目前的研究不允许确定因果关系，但结果表明AML患者可能受益于治疗期间的抗炎干预，以减轻躯体症状体验。
The aim of the study was to assess the association inflammation with symptom burden in patients with acute myeloid leukemia (AML), assessed before and during remission induction chemotherapy (IC). Patients with AML (n = 95) were followed from baseline (before IC) to the third week of IC for severity of self-reported somatic symptoms (assessed with the MD Anderson Symptom Inventory) and plasma levels of 13 inflammation-related biomarkers (n = 64). A composite symptom burden severity score was computed as the average score of the six most severe somatic symptoms i.e., fatigue, disturbed sleep, drowsiness, dry mouth, lack of appetite, and pain. Results from cross-sectional analyses showed that inflammation was weakly associated with symptom burden before IC (multiple regression model, explained variance = 10%) but this association grew stronger during IC (week 3 explained variance = 35%). About half of the sample showed a change over time in symptom severity. These changes were not reflected in similar changes over time in inflammatory markers, suggesting that it is the absolute concentration of a given inflammatory marker at a given time point rather than its relative change over time that is of importance. In conclusion, inflammation was strongly associated with symptom burden only during IC, possibly because expression of cytokines only then becomes relevant for regulation of symptom burden. While the current study does not allow for determination of causality, the results suggest that AML patients might benefit from anti-inflammatory interventions during treatment to alleviate somatic symptom experience.