High IL-6 expression in the tumor microenvironment is associated with poor prognosis of patients with extranodal natural / killer T-cell lymphoma (ENKTL)

ABSTRACT

Objectives: Extranodal natural/killer T-cell lymphoma (ENKTL) is a rare subtype of T cell non-Hodgkin’s lymphoma. Current clinical prognostic models for ENKTL still have their limitations. Validated prognostic models for ENKTL have not yet been established.

Methods: Tumor microenvironment IL-6 was measured by immunohistochemistry in 78 ENKTL patients.

Results: Patients with negative IL-6 expression in the tumor microenvironment have a longer PFS (56.0 months vs. 25.6 months, p < 0.001) and OS (96.0 months vs. 43.3 months, p < 0.001). In the multivariate analysis, tumor microenvironment IL-6 [p = 0.048, HR = 1.76(1.00–3.08)] and extranodal involvement [p = 0.001, HR = 2.69(1.50–4.82)] were independent prognostic factors for PFS. Tumor microenvironment IL-6 [p = 0.033, HR = 2.69 (1.08–6.67)], Ann Arbor stage [p = 0.002, HR = 2.77 (1.47–5.23)] and B symptom [p = 0.027, HR = 2.02 (1.08–3.78)] were independent prognostic factors for OS.

Expert opinion: A high IL-6 expression was related to poor survival, which may be a valuable biomarker for prognostic evaluation at baseline in ENKTL. These results showed that anti-IL-6R may be a potential targeted therapy for the treatment of advanced or relapsed ENKTL.

KEYWORDS:

• ENKTL
• tumor microenvironment IL-6
• serum IL-6
• immunotherapy
• biomarker

Author contributions

Qixiang Rong, Yan Gao and Huiqiang Huang designed the study. Qixiang Rong, Qichun Cai, Xiaoxiao Wang and Bing Bai drafted the manuscript. Qixiang Rong, Yan Gao, Liqin Ping, Haixia He and Huilan Rao collected and assembled data. Qixiang Rong, Yujing Zhang, Zhiming Li did the statistical analysis. Qixiang Rong, Qingqing Cai, and Wenqi Jiang analyzed and interpreted the data.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This work was supported by the Sun Yat-sen University Cancer Center.