Both C.E.F. and M.T. contributed equally to this work
C-reactive protein is a strong predictor for anaemia in renal cell carcinoma: role of IL-6 in overall survival
Article first published online: 10 NOV 2010
© 2010 THE AUTHORS. BJU INTERNATIONAL © 2010 BJU INTERNATIONAL
Volume 107, Issue 12, pages 1893–1898, June 2011
How to Cite
Falkensammer, C. E., Thurnher, M., Leonhartsberger, N. and Ramoner, R. (2011), C-reactive protein is a strong predictor for anaemia in renal cell carcinoma: role of IL-6 in overall survival. BJU International, 107: 1893–1898. doi: 10.1111/j.1464-410X.2010.09817.x
- Issue published online: 27 MAY 2011
- Article first published online: 10 NOV 2010
- Accepted for publication 2 July 2010
- renal cell carcinoma;
- c-reactive protein;
Study Type – Prognostic (case series)
Level of Evidence 4
What’s known on the subject? and What does the study add?
The incidence of renal cell carcinoma (RCC)-associated anaemia has been linked with more aggressive tumours. Metastatic RCC patients with elevated IL-6 levels have significantly decreased haemoglobin concentrations.
We elucidate the association of progression of advanced RCC with anaemia and different factors influencing tumour-associated anaemia. Interleukin-6 emerges as a possible target to treat cancer-related anaemia in metastatic RCC.
• To elucidate the association of progression of advanced renal cell carcinoma with anaemia and investigate factors influencing tumor-associated anaemia.
PATIENTS AND METHODS
• We analyzed different clinical variables to study associations with anaemia in 86 metastatic renal cell carcinoma patients.
• 45 (52%) of patients had already developed anaemia prior to therapy.
• Anaemic patients had an increase in the serum markers C-reactive protein (CRP), IL-6 and erythropoietin (EPO). In addition we observed substantial correlation between IL-6 and CRP serum levels (R = 0.639, P < 0.0001).
• Univariate logistic regression analysis revealed that patients with IL-6 >10 pg/mL had a considerable increase in risk for anaemia (odds ratio 3.86, P= 0.003).
• In addition, patients with CRP >0.7 mg/dL had a very strong increase in risk for anaemia (OR = 14.08, P < 0.0001).
• Stepwise multivariate logistic regression analysis confirmed CRP >0.7 mg/mL as the only independent predictor for anaemia. Cox-regression modeling selected serum IL-6 as the strongest independent prognostic indicator (hazard ratio 3.58, P < 0.0001).
• Anaemia depends on serum IL-6, which is a strong inductor of CRP and regulator of the iron-transport. Serum IL-6 may be considered as a target to treat cancer-related anaemia.