Malignant causes of fever of unknown origin

Foggo, Vanessa; Cavenagh, Jamie

doi:10.7861/clinmedicine.15-3-292

Cited by 45 publications

(34 citation statements)

References 19 publications

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“…Recently, another interesting development has been seen that thalidomide enhances the release of IL-2 and IFN from activated T cells, inhibits the immunosuppressive activity of regulatory T cells and increases NK-cell mediated cytotoxicity, thus inhibiting the release of TNF and other cytokines, including IL-6. However, it is still difficult to acquire reliable data from M-HLH because these reports are mainly based on case reports or other types of HLH [ 69 ].…”

Section: Introductionmentioning

confidence: 99%

A systematic review of malignancy-associated hemophagocytic lymphohistiocytosis that needs more attentions

et al. 2017

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As an infrequent but potentially life-threatening hyperinflammatory syndrome, hemophagocytic lymphohistiocytosis (HLH) is clinically characterized with prolonged fever, hepatosplenomegaly, cytopenia, hypertriglyceridemia, hyperferritinemia and hemophagocytosis in bone marrow, liver, spleen or lymph nodes. Malignancy-associated HLH (M-HLH), one type of acquired HLH, usually presents variable overlaps of symptoms with other types of HLH, thus resulting in higher incidence of misdiagnosis and mortality. In recent years, with the increasing awareness to this disease, the diagnosis and management of HLH have gained more and more attention, and improvements have been made accordingly. As a result, the survival of patients is greatly prolonged. However, there is still no consensus on the diagnostic criteria and treatment strategies due to lack of large samples or prospective clinical trials. In order to improve recognition and diagnosis, and provide guidance regarding the treatment of M-HLH, the Study Group in HLH Subtypes of the Histiocyte Society has developed consensus recommendations for the diagnosis and management of M-HLH in 2015. In the present article, we summarized and discussed some updated understandings in M-HLH.

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Section: Introductionmentioning

confidence: 99%

A systematic review of malignancy-associated hemophagocytic lymphohistiocytosis that needs more attentions

et al. 2017

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“…Third, fever may be a crucial factor in survival; PSM analysis also verified that patients with ICC with fever had worse prognosis than those without fever. Fever is caused by inflammatory cytokines that are released by tumors, especially endogenous pyrogen‐related cytokines such as interleukin‐1, interleukin‐6, interleukin‐8, and tumor necrosis factor . In renal cell carcinomas and lymphomas, these cytokines have been associated with increased incidence of neoplastic fever and advanced stage .…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Prognostic Factors of Patients with Intrahepatic Cholangiocarcinoma with Fever: A Propensity Score Matching Analysis

et al. 2019

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Background Patients with intrahepatic cholangiocarcinoma (ICC) rarely present fever as the initial symptom. We aimed to identify clinical characteristics and prognostic factors for these feverish patients. Subjects, Materials, and Methods This study retrospectively reviewed 31 patients with ICC with fever (≥38.0°C) treated at our hospital between January 2002 and December 2014. A propensity score was used to match patients with and without fever at a ratio of 1:2. Results Patients with ICC with fever had higher serum γ‐glutamyl transferase and carcinoembryonic antigen levels, larger tumors, poorer tumor differentiation, and worse prognosis (all p < .05) than those without fever. This was supported by propensity score matching (PSM) analysis. Univariate and multivariate analyses indicated that microvascular invasion, hilar lymph node metastasis, and temperature ≥ 38.6°C were related to prognosis. Patients with ICC with fever had higher levels of leucocytes, neutrophils, neutrophil‐to‐lymphocyte ratio (NLR), and platelet‐to‐lymphocyte ratio (PLR) in peripheral blood before and after PSM analysis. Body temperature positively correlated with leucocytes (r = 0.599, p < .001), neutrophils (r = 0.644, p < .001), NLR (r = 0.681, p < .001), and PLR (r = 0.457, p = .010). Conclusion Patients with ICC with fever ≥38.0°C and ≥38.6°C had poor and extremely poor prognosis, respectively. Radical surgical treatment may improve the prognosis of patients with ICC with fever <38.6°C. However, systemic therapy (e.g., anti‐inflammatory and immune therapy) may be preferable to surgery for these patients with fever ≥38.6°C. Implications for Practice Patients with intrahepatic cholangiocarcinoma (ICC) with fever (≥38.0°C) as the initial symptom are extremely rare. Because their symptoms are similar to those of liver abscess, diagnosis is challenging, and most of these patients are already at an advanced stage at the time of diagnosis. Patients with ICC with fever had different clinical characteristics and worse prognosis than those without fever. The prognosis of those with temperature <38.6°C would be improved by timely surgical intervention. Those with fever ≥38.6°C had an extremely dismal outcome, although they all received radical surgical treatment. New therapeutic strategies are needed to improve survival for patients with ICC with temperature ≥38.6°C.

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“…These circadian mechanisms might be extrapolated to cancer as well. For instance, in patients with lymphoma, cytokines are strongly released by malignant leukocytes during the night, leading to nocturnal fever peaks [101]. Moreover, in pancreatic and colorectal cancer, Il-6 has been shown to support the formation of a pro-metastatic niche in the liver [102].…”

Section: Biological Cycles and Cancermentioning

confidence: 99%

Do malignant cells sleep at night?

Cortés‐Hernández¹,

Eslami-S²,

Dujon

et al. 2020

Genome Biol

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Biological rhythms regulate the biology of most, if not all living creatures, from whole organisms to their constitutive cells, their microbiota, and also parasites. Here, we present the hypothesis that internal and external ecological variations induced by biological cycles also influence or are exploited by cancer cells, especially by circulating tumor cells, the key players in the metastatic cascade. We then discuss the possible clinical implications of the effect of biological cycles on cancer progression, and how they could be exploited to improve and standardize methods used in the liquid biopsy field.

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Malignant causes of fever of unknown origin

Cited by 45 publications

References 19 publications

A systematic review of malignancy-associated hemophagocytic lymphohistiocytosis that needs more attentions

A systematic review of malignancy-associated hemophagocytic lymphohistiocytosis that needs more attentions

Clinical Characteristics and Prognostic Factors of Patients with Intrahepatic Cholangiocarcinoma with Fever: A Propensity Score Matching Analysis

Do malignant cells sleep at night?

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