Inflammatory Biomarkers Can Differentiate Acute Lymphoblastic Leukemia with Arthropathy from Juvenile Idiopathic Arthritis Better Than Standard Blood Tests - 05/07/23
, Mia Glerup, MD, PhD 2, Dirk Foell, MD, PhD 3, Christoph Kessel, MD, PhD 3, Helmut Wittkowski, MD 3, Lillemor Berntson, MD, PhD 4, Anders Fasth, MD, PhD 5, Susan Nielsen, MD 6, Ellen Nordal, MD 7, Marite Rygg, MD, PhD 8, 9, Henrik Hasle, MD, PhD 2, Troels Herlin, MD, PhD 2and the
Nordic Study Group of Pediatric Rheumatology (NoSPeR) group
Abstract |
Objective |
To evaluate the predictive value of biomarkers of inflammation like phagocyte-related S100 proteins and a panel of inflammatory cytokines in order to differentiate the child with acute lymphoblastic leukemia (ALL) from juvenile idiopathic arthritis (JIA).
Study design |
In this cross-sectional study, we measured S100A9, S100A12, and 14 cytokines in serum from children with ALL (n = 150, including 27 with arthropathy) and JIA (n = 236). We constructed predictive models computing areas under the curve (AUC) as well as predicted probabilities in order to differentiate ALL from JIA. Logistic regression was used for predictions of ALL risk, considering the markers as the respective exposures. We performed internal validation using repeated 10-fold cross-validation and recalibration, adjusted for age.
Results |
In ALL, the levels of S100A9, S100A12, interleukin (IL)-1 beta, IL-4, IL-13, IL-17, matrix metalloproteinase-3, and myeloperoxidase were low compared with JIA (P < .001). IL-13 had an AUC of 100% (95% CI 100%-100%) due to no overlap between the serum levels in the 2 groups. Further, IL-4 and S100A9 had high predictive performance with AUCs of 99% (95% CI 97%-100%) and 98% (95% CI 94%-99%), respectively, exceeding both hemoglobin, platelets, C-reactive protein, and erythrocyte sedimentation rate.
Conclusions |
The biomarkers S100A9, IL-4, and IL-13 might be valuable markers to differentiate ALL from JIA.
Il testo completo di questo articolo è disponibile in PDF.Keywords : childhood acute lymphoblastic leukemia, juvenile idiopathic arthritis, arthropathy, S100A9, S100A12, interleukin-4, interleukin-13, cytokines
Abbreviations : ALL, AUC, CD25, JADAS71 score, JIA, CCL-2, CRP, ESR, IL, MMP-3, MPO, WBC
Mappa
| This work was supported by Arvid Nilsson’s under grant 1780631; Danish Childhood Cancer Foundation under grant 2017-1945 and grant 2020-6653; and Ølufgard Memorial Fund under grant 25734. No sponsors or funders (other than the named authors) played any role in study design, data collection and analysis, decision to publish or preparation of the manuscript. The authors have no conflicts of interest to disclose. |
Vol 258
Articolo 113406- luglio 2023 Ritorno al numero
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