Prognostic implication of serum levels of IL-6 and IL-10 in children and adolescents with aggressive mature B-cell non-Hodgkin lymphoma.

BACKGROUND: Aggressive mature B-cell non-Hodgkin lymphoma (B-NHL) is the most common subtype of non-Hodgkin lymphoma in children and adolescents. However, little progress has been made in determining the prognostic factors of children and adolescents with B-NHL. Based on the effect of cytokines in other cancer types, this study explored the effect of cytokines on the prognosis of children and adolescents with B-NHL. METHODS: The levels of serum cytokines including interleukin-2 (IL-2), IL-4, IL-6, IL-10, tumor necrosis factor-α (TNF-α), and interferon-γ (IFN-γ) were detected at diagnosis. Correlations between cytokines, clinical characteristics, and treatment outcomes were retrospectively analyzed. RESULTS: In total, 139 patients aged < 18 years with newly diagnosed mature B-NHL were enrolled. Patients with elevated IL-6 levels at diagnosis (n = 35) had worse 5-year event-free survival (85.3% vs. 97.1%, p = 0.01) and overall survival (OS) rates (91.2% vs. 99.0%, p = 0.02) than those with normal IL-6 levels. Patients with elevated IL-10 (n = 35) had worse 5-year OS rates (91.4% vs. 99.0%, p = 0.02) than those with normal IL-10 levels. Cox multivariate analysis identified elevated IL-6 levels at diagnosis as an independent adverse prognostic factor in pediatric B-NHL. Elevated IL-6 levels correlated positively with IL-10 levels, and patients with simultaneously elevated IL-6 and IL-10 levels had the worst prognosis in the entire cohort. CONCLUSIONS: Our study suggests that elevated serum IL-6 and IL-10 levels at diagnosis are associated with poor prognosis in pediatric mature B-NHL and may have the potential to inform risk stratification. Future prospective, multi-center studies are required to validate these findings.