
Patient Stress Is Linked With Cancer Cell Proliferation and Elevated Cytokines in CLL
While it is well understood that psychological distress is a major side effect of cancer and its treatment, and that stress can have a strong impact on patients’ quality of life, a new study indicated that stress is linked with markers of more advanced disease in patients with chronic lymphocytic leukemia (CLL), the most common form of leukemia among adults.
While it is well understood that psychological distress is a major side effect of cancer and its treatment, and that stress can have a strong impact on patients’ quality of life, a new study indicated that stress is linked with markers of more advanced disease in patients with chronic lymphocytic leukemia (CLL), the most common form of leukemia among adults.
The study, recently
The investigators found that higher levels of stress predicted higher ALCs (P  < .05). Higher stress also predicted higher levels of the inflammatory cytokines tumor necrosis factor alfa (TNF) (P  < .05) and interleukin 16 (IL-16) (P < .01). TNF is particularly crucial in CLL, because it increases the proliferation and viability of malignant cells. IL-16 is believed to mediate communications between B cells and T cells within lymph node follicles, and may suppress effector T-cell function.
Stress was also associated with higher levels of chemokine ligand 3 (CCL 3) (P  < .05). CCL 3, which the authors of the study say not has not been assessed before in relationship to stress, is of particular note: this cytokine facilitates development of CLL cells in the spleen and lymph nodes.
Even after controlling for older age, male sex, the presence of comorbidities, the number of prior treatments, and deletion of the short arm of chromosome 17—all of which are predictive of poorer outcomes in CLL—the associations between stress and elevated markers of disease were still apparent.
“All 4 variables we measured are related to prognosis in CLL patients, so they have a lot of relevance,” Barbara L. Andersen, PhD, lead author of the study and professor of psychology at The Ohio State University, said in a statement. “It’s more evidence of the importance of managing stress in cancer patients,” she added.
The investigators say that their data are consistent with the hypothesis that stress is a negative interface to an already weakened immune system, but they add that further data will be needed to help clarify these responses and their relationship to relapse in patients with CLL.
Reference
Andersen BL, Goyal NG, Weiss DM, et al. Cells, cytokines, chemokines, and cancer stress: a biobehavioral study of patients with chronic lymphocytic leukemia. Cancer. 2018 Aug 1;124(15):3240-3248. doi: 10.1002/cncr.31538.
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