Study of serum cytokines (interleukin-6 and tumor necrosis factor-alpha) in acute leukemias

Objectives: The objectives of this study were to assess the cutoff levels of interleukin (IL)-6 and tumor necrosis factor-alpha (TNF-alpha) for predicting acute leukemia with special attention to their correlation with blast counts in leukemia subtypes of acute lymphoblastic leukemia (ALL), acute myeloid leukemia, and mixed phenotypic acute leukemia. Methods: This observational cross-sectional case–control study was done from September 2018 to March 2020. A total of 35 newly diagnosed patients of acute leukemia were taken as cases and compared with 140 healthy controls. Complete phenotyping and blood film analysis was done for the cases. The serum levels of IL-6 and TNF-alpha levels were assessed and compared among cases and controls. The levels of IL-6 and TNF-alpha were correlated with blast counts of subtypes of acute leukemia. P < 0.05 was considered statistically significant. Results: Compared to controls, acute leukemia cases had significantly higher levels of IL-6 median interquartile range value (12.39 [8.056–136.894] vs. 8.27 [6.477–10.849]) and TNF-alpha (192.48 ± 633.01 vs. [20.63 ± 8.17]) with P < 0.05. TNF-alpha was found to be the better predictor of acute leukemias at cutoff of >24.906 with sensitivity of 71.43% as compared to IL-6 (Sn of 48.57%). Only TNF-alpha had a significant correlation with absolute blast count in ALL cases (r = 0.579, P = 0.0118). Conclusion: It can be concluded that an aberrant increased production of the pro-inflammatory cytokines IL-6 and TNF-alpha is shown in the acute leukemia patients as compared to the healthy controls. TNF-alpha is a better marker among both the cytokines for predicting acute leukemia with significant correlation with blast counts in ALL.