Interleukin-6 as a predictive marker for early response to induction chemotherapy in acute myeloblastic leukaemia

Background The early complete morphological remission (CR) after induction chemotherapy is a major independent prognostic factor for both achievements of CR and long-term outcome in acute myeloid leukemia. we studied the correlation between the serum IL-6 levels and the early morphological CR aiming to use serum level of IL-6 instead of invasive painful BM aspiration as a predictive factor for the early response to induction chemotherapy in AML patients. Methods During the study period from February 2015 to May 2016, we investigate 36 patients. Eligibility criteria were the evidence of a diagnosis of AML (not AML-M3), both sexes, age of 18-60 years, Patients with a performance status of 0 to 2, and adequate organs functions. We excluded 6 ineligible patients from the study. All patients received induction chemotherapy of cytarabine and anthracycline in the standard “7 + 3” regimen. We did day 14 BM aspiration to detect the presence of early morphological complete remission (≤ 5% marrow blasts) and blood sampling for measurement of the interleukin-6 at presentation and day 14 of starting of induction chemotherapy. Results This study included eligible 30 newly diagnosed AML patients with age ranged from 18-60 years (Mean ± SD, 39.53 ± 13.54). The range of marrow blasts at presentation was 20-93% with the Mean ± SD of 58.10% ± 23.10%. As regards the levels of IL-6 at presentation, the mean ± SD was 42.46 ± 28.10 pg/ml and the range was 21.3 - 140.6. Day 14 BMA revealed 8 out of the 30 enrolled patients achieved complete morphological remission (≤ 5 % marrow blasts). There was a statistically significant decrease in IL-6 serum level in patients achieved morphological CR (mean + SD, 18.26 ± 5.75; range, 10.7 - 28.9 pg/ml) than those did not (mean + SD, 26.07 ± 4.78; range, 21.3 - 32.7 pg/ml) (P = 0.017). At Day 14 of induction chemotherapy, there was a significant positive correlation between IL-6 and marrow blasts (r = 0.745, P = 0.000*). Conclusions Interleukin-6 is suggested to be a good predictive marker for early response to induction chemotherapy in patients with acute myeloblastic leukemia and may be used instead of invasive day 14 BM aspiration as a marker of this response. Legal entity responsible for the study Faculty of Medicine, Assiut University. Funding Has not received any funding. Disclosure All authors have declared no conflicts of interest.