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Cancer. 2005 Jun 22; [Epub ahead of print] Related Articles, Links


Cognitive impairment, fatigue, and cytokine levels in patients with acute
myelogenous leukemia or myelodysplastic syndrome.

Meyers CA, Albitar M, Estey E.

Department of Neurooncology, The University of Texas M. D. Anderson Cancer
Center, Houston, Texas.

BACKGROUND: The objective of the current study was to assess the
correlations between cognitive function, fatigue, quality of life, and
circulating cytokine levels in patients with acute myelogenous leukemia
(AML) and myelodysplastic syndrome (MDS). METHODS: Fifty-four patients with
AML/MDS were seen for pretreatment evaluation of their cognitive function
and symptoms. Fifty percent of the sample was reevaluated 1 month later,
when response to protocol chemotherapy was assessed. RESULTS: A significant
proportion of patients had impaired cognitive function prior to the
institution of chemotherapy. Sixty-five percent of patients also experienced
significant fatigue. Levels of the circulating cytokines interleukin 1
(IL-1), IL-1 receptor antagonist (IL-1RA), IL-6, IL-8, and tumor necrosis
factor-alpha (TNF-alpha) were elevated highly compared with normal controls.
Higher IL-6 levels were associated with poorer executive function, whereas
higher IL-8 levels were associated with better memory performance. IL-6,
IL-1RA, and TNF-alpha levels were related to ratings of fatigue. Fatigue and
cognitive dysfunction were unrelated. Hemoglobin levels were not associated
significantly with either cognitive dysfunction or fatigue. Patients who
obtained a complete response tended to have better fine motor control at
baseline and lower circulating IL-1 levels. Treatment did not have a
significant impact on cognition, although fatigue levels tended to increase.
CONCLUSIONS: Patients with AML/MDS are highly symptomatic and experience
cognitive impairment and fatigue before the initiation of their treatment.
The current results indicated a correlation between these symptoms and
levels of circulating cytokines, providing some support to the hypothesis
that cancer-related symptoms are related at least in part to
cytokine-immunologic activation. Elucidation of immunologic correlates of
symptoms will allow for targeted interventions. Cancer 2005. (c) 2005
American Cancer Society.

PMID: 15973668 [PubMed - as supplied by publisher]


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