Changes in Blood Cytokines of Terminal Cancer Patients

We studied changes in blood cytokines of terminal cancer patients to elucidate the relation between changes in cytokines and cachectic conditions of the patients. The subjects were 28 patients with carcinoma who consented to participate in the clinical trial. Levels of cytokines were examined in 2 ml blood samples saved for this measurement at routine blood collections, in order to study the relation between the cytokines data and physical observations when patients had their blood collected. Six types of cytokines considered to be associated with cachexia, TNF, IL-1, IL-6, IFN-γ, LIF, and PTH γ P, were measured. In 7 of the first 8 patients at the start of this study, IL-6 only was detected, and TNF was detected in the remaining patient. Next, only IL-6 was measured in the next 20 patients. Ten patients in whose blood IL-6 was measured 40 days before their death, showed a sharp elevation of IL-6 just before their death. In 6 of the 10 patients, 100 pg/ml or more of IL-6 was detected 7 days before their death. The average period from detection to the day of death was 2.0 days, with a standard deviation of 1.5 days. Progression of carcinoma is believed to induce various types of cytokines, which cause loss of appetite (decreasing food intake), degradation of fat and decay of muscle, which together may cause patients to become cachectic. Only the level of IL-6 was elevated significantly among the 6 cytokines studied in this test, and this elevation occurred just before patients died (about 1 week). We conclude that IL-6 is not associated with cachexia in the early stage of carcinoma.