Serum cytokines and chronic fatigue in adults surviving after childhood leukemia and lymphoma

Introduction: Fatigue is a common and distressing symptom in all phases of the cancer trajectory. Chronic fatigue (CF) is defined as fatigue with duration >= 6 months. The etiology of CF in cancer survivors is poorly understood, but a link to inflammatory activity has been suggested. In the present study we explored the relation between CF and the levels of 17 cytokines among a national representative sample of 232 adult survivors after childhood lymphoma and acute lymphoblastic leukemia (ALL). Methods: Chalder's fatigue questionnaire assessed CF. The sera of the survivors were analyzed for 27 cytokines, where of 17 were detectable. Results: Median age at survey and diagnosis was 29.7 years (range 18.6-54.5 years) and 9.6 years (range 0.3-18.0 years), respectively. Median follow-up time was 21.5 years (range 7.1-40.0 years). CF was not associated with increased levels of any of the 17 detectable cytokines when all three diagnostic groups were included in the analyses. In sub-analyses of the non-Hodgkin lymphoma survivors only, those with CF had significant higher levels of IL-9, FGF, PDGF and eotaxin compared to those without CF (p < 0.05). Gender, age, diagnosis, obesity, or reduced heart function did not impact upon the results. Differences in cytokine levels between the diagnostic groups were observed irrespective of the presence/absence of CF. Conclusion: This study could not confirm a relation between levels of cytokines and CF in adults who survived childhood lymphoma and ALL except for among NHL survivors. Despite the broad spectrum of cytokines and relatively large sample, small aberrances may not have been traced. (C) 2013 Elsevier Inc. All rights reserved.