Tumor necrosis factor-alpha in malignant disease.

Purpose: Due to its important role in immunoregulation, we have investigated serum levels of tumor necrosis factor-alpha (TNF alpha), in children with newly diagnosed, untreated, malignant disease.

Patients and methods: These levels have been related to the presence of infection and to the serum content of three other cytokines, namely interleukin-1 beta, interleukin-2, and interferon-gamma. All cytokine analyses were performed using highly sensitive radioimmunoassays.

Results: Children with leukemia had higher mean levels of TNF alpha (63.6 +/- 12.3 pg/ml) than did children with solid tumors (21.5 +/- 4.2 pg/ml) and control patients (10.5 +/- 2.6 pg/ml). TNF alpha levels in patients did not correlate with the levels of the other cytokines or with the presence of infection.

Conclusions: Children with malignant disease often have elevated TNF alpha levels. This elevation is dependent on the malignant disease process itself, and could either reflect the host immunological response or tumor cell production of TNF alpha.