Serum Interleukin-6 is Not Linked with Sleep-Quality, Restless Legs Syndrome, and Depression, But with 6-Month Survival in Hematological Malignancies

Abstract

Background:Serum interleukin (IL)-6 has been found to be associated with sleep quality, mood, and survival in patients with solid tumors. Results in these studies were confounded by knowledge of diagnosis to study subjects. Moreover, such data among subjects with hematological malignancies and data regarding restless legs syndrome is limited. The present study was, therefore, conducted to assess the sleep quality, depression, and restless leg syndrome in hematological malignancies and to study if there is any role of IL6 associated with it.Methods:Sixty-six subjects having hematological malignancy were included in this study after excluding the potential confounders. Sleep quality was examined using Pittsburg Sleep Quality Index, depression by the Patient Health Questionnaire-9. Diagnosis of RLS was made through clinical examination. Serum for measurement of IL-6 was collected at baseline and after 1 month of initiation of chemotherapy. Patients were followed up for 6 months.Results:Average age of study subjects was 50.16 years with male predominance. Nearly 22.7% had clinical depression, 28.8% had poor quality sleep, and restless legs syndrome (RLS) was reported in 6.1% cases. Nearly 22.7% patients died at 6 months. Disturbed sleep at baseline was associated with depression (odds ratio [OR] =7.89) and poor 6 months survival. Serum IL-6 did not show any association with sleep quality, restless-legs-syndrome, and depression. However, baseline high level of serum IL-6 (OR = 26.06) and low level after chemotherapy (OR = 0.03) were associated with poor survival at 6 months.Conclusion:Poor quality sleep, depression, and RLS are prevalent among adult subjects with hematological malignancies. Sleep disturbance, high pretreatment inflammatory and lowering of inflammatory load after chemotherapy increase likelihood for poor prognosis. Serum IL-6 did not show any association with sleep quality, restless legs syndrome and depression.

Sleep During Oncological Treatment – A Systematic Review and Meta-Analysis of Associations With Treatment Response, Time to Progression and Survival

“…The most frequently investigated cancers were colorectal cancer reported in six studies ( Mormont et al, 2000 ; Maisey et al, 2002 ; Innominato et al, 2009 , 2012 , 2015 ; Lévi et al, 2014 ), non-small cell lung cancer in six studies ( Naughton et al, 2002 ; Braun et al, 2011 ; Zhao et al, 2013 ; Chang and Lin, 2014 ; Gottfried et al, 2020 ; Kuo et al, 2020 ), and breast cancer in five studies ( Geels et al, 2000 ; Kramer et al, 2000 ; Zhao et al, 2013 ; Chang and Lin, 2014 ; Palesh et al, 2014 ). In four studies, the sample consisted of mixed cancer populations ( Zhao et al, 2013 ; Chang and Lin, 2014 ; Collins et al, 2017 ; Chandra et al, 2019 ). Twenty-four studies included patients with advanced disease, of which 10 studies included mixed cancer stages, and two studies failed to report cancer stage ( Geels et al, 2000 ; Chandra et al, 2019 ).…”

“…In four studies, the sample consisted of mixed cancer populations ( Zhao et al, 2013 ; Chang and Lin, 2014 ; Collins et al, 2017 ; Chandra et al, 2019 ). Twenty-four studies included patients with advanced disease, of which 10 studies included mixed cancer stages, and two studies failed to report cancer stage ( Geels et al, 2000 ; Chandra et al, 2019 ).…”

“…The four available response categories are; “Not at all,” “a little,” “quite a bit,” and “very much” ( Aaronson et al, 1993 ). The Pittsburgh Sleep Quality Index (PSQI), a 19-item self-rated questionnaire that assesses sleep quality and disturbances over a 1-month period was used in three studies ( Zhao et al, 2013 ; Collins et al, 2017 ; Chandra et al, 2019 ). One study ( Gottfried et al, 2020 ) reported sleep based on one of two questions: “difficulty falling asleep?” and “frequent arousals at night?”.…”

LAG3/CD4 Genes Variants and the Risk for Restless Legs Syndrome

“…IL-6 and TNF-α were not related to the presence of PLMS in RLS patients [ 18 ]. Serum IL-6 was increased in patients with end-stage kidney disease and RLS compared with those without RLS [ 18 ] and was similar in patients with hematologic malignancies with and without RLS [ 24 ]. There is a description of the up-regulation or down-regulation of several proteins involved in inflammatory processes in patients with RLS compared with controls in proteomic studies in serum/plasma [ 25 , 26 ].…”

“…IL-6 and TNF-α were not related to the presence of PLMS in RLS patients [ 18 ]. Serum IL-6 was increased in patients with end-stage kidney disease and RLS compared with those without RLS [ 18 ] and was similar in patients with hematologic malignancies with and without RLS [ 24 ].…”