Cytokine Profile in Nasal-Type Extranodal Nature Killer/T-Cell Lymphoma-Associated Hemophagocytic Syndrome

Abstract

Background: The role of cytokines in predicting the diagnosis of extranodal nature killer/T-cell lymphoma-associated hemophagocytic syndrome (ENKL-LAHS) has been reported. This retrospective study aimed to analyze the cytokine profile in nasal type ENKL-LAHS. Methods: Sixty patients diagnosed with extranodal NK/T-cell lymphoma, nasal type (ENKL) were divided into two groups: ENKL-LAHS group (n = 30) and ENKL group (n = 30), based on the presence of lymphoma-associated hemophagocytic syndrome (LAHS). Peripheral blood cytokine levels were compared between the two groups. A logistic regression model was applied to assess the relationship between serum cytokine levels and ENKL-LAHS. The predictive values of serum cytokines for ENKL-LAHS were determined through receiver operating characteristic (ROC) curves. Results: Compared to the ENKL group, the ENKL-LAHS group exhibited significantly elevated levels of granulocyte-macrophage colony-stimulating factor (GM-CSF) (p < 0.001), granulocyte-colony stimulating factor (G-CSF) (p = 0.001), interferon-gamma (IFN-γ) (p = 0.003), interleukin (IL)-10 (p < 0.001), IL-15 (p < 0.001), IL-1 receptor antagonist (IL-1ra) (p < 0.001), IL-8 (p < 0.001), macrophage inflammatory protein 1α (MIP-1α) (p < 0.001), interferon-gamma inducible protein-10 (IP-10) (p < 0.001), MIP-1β (p < 0.001) and tumor necrosis factor α (TNF-α) (p < 0.001). Conversely, the levels of monocyte chemoattractant protein-1 (MCP-1) (p = 0.002) and soluble CD40 ligand (sCD40L) (p < 0.001) were significantly decreased. Logistic multivariate analysis revealed that the concentrations of cytokines IL-8 (p < 0.001), IL-10 (p = 0.016), IL-15 (p = 0.026), IFN-γ (p = 0.034), GM-CSF (p = 0.012), G-CSF (p = 0.001), sCD40L (p < 0.001), and TNF-α (p = 0.024) correlated with ENKL-LAHS. ROC curve analysis showed that the sCD40L/GM-CSF/IL-8 model exhibited better predictive value (the area under the curve (AUC): 0.973). Conclusion: sCD40L, GM-CSF, and IL-8 have a strong predictive value for ENKL-LAHS and can serve as reliable predictors for this condition.