Prognostic value of systemic inflammation markers in non-Hodgkin lymphoma and chronic lymphocytic leukemia

Dzis I.Y.¹, Tomashevska O.Ya.², Dzis Y.I.², Danysh O.Y.¹

• ¹State institution «Institute of blood pathology and transfusion medicine of the National Academy of Medical Sciences of Ukraine», Lviv
• ²Lviv National Medical University named after Danylo Halytsky

Summary. Objective — to clarify relationships between markers of systemic inflammation and prognosis in patients with B-cell non-Hodgkin lymphoma (NHL) and chronic lymphocytic leukemia (CLL). Object and methods. We examined 45 patients aged 26–80 years: 36 with NHL and 9 with CLL, including 19 patients with newly diagnosed disease. We determined levels of interleukin (IL)-6, tumor necrosis factor (TNF)-α, blood coagulation parameters and overall survival rates during the follow-up period of 35 months. Results. It was established that the systemic inflammatory response is associated with negative prognostic markers in patients with NHL and CLL, including the progression of the disease, anemia, hypercoagulability and the risk of thrombosis. There was a significant worsening in the overall survival of patients with detected active systemic inflammation before initiation of treatment, such as erythrocyte sedimentation rate >30 mm/h, levels of TNF-α ≥1.45 pg/mL, IL-6 >2.0 pg/mL, fibrinogen ≥6 g/L, together with hemoglobin levels <120 g/L and soluble fibrin monomer complex (SFMC) levels >4 mg/dL. Among inflammatory markers, the IL-6 level >2 pg/mL is an independent predictor of death from any cause. Conclusion. Levels of IL-6, TNF-α, fibrinogen and erythrocyte sedimentation rate along with hemoglobin and SFMC should be used as an additional prognostic criteria in patients with NHL and CLL.