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 Blood, 1 July 2005, Vol. 106, No. 1, pp. 362-367.
Prepublished online as a Blood First Edition Paper on March 17, 2005; DOI 10.1182/blood-2005-01-0160.

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RED CELLS

Hemoglobin levels correlate with interleukin-6 levels in patients with advanced untreated epithelial ovarian cancer: role of inflammation in cancer-related anemia

Antonio Macciò, Clelia Madeddu, Daniela Massa, Maria C. Mudu, Maria R. Lusso, Giulia Gramignano, Roberto Serpe, Gian Benedetto Melis, and Giovanni Mantovani

From the Department of Obstetrics and Gynecology, Sirai Hospital, Carbonia, Italy; the Department of Medical Oncology, University of Cagliari, Cagliari, Italy; and the Department of Obstetrics and Gynecology, University of Cagliari, Cagliari, Italy.

Anemia occurs in more than 30% of patients with epithelial ovarian cancer before any surgery. High levels of proinflammatory cytokines and increased oxidative stress may contribute to the development of cancer-related anemia. We assessed a population of previously untreated patients with advanced epithelial ovarian cancer to evaluate whether there was a correlation between hemoglobin (Hb) and parameters of inflammation and oxidative stress, stage of disease, and performance status (PS). In 91 patients with epithelial ovarian cancer and 95 healthy women matched for age, weight, and height, levels of Hb, C-reactive protein (CRP), fibrinogen (Fbg), proinflammatory cytokines, leptin, reactive oxygen species (ROS), and antioxidant enzymes were assessed at diagnosis before treatment. The correlations between Hb, parameters of inflammation and oxidative stress, stage, and PS were evaluated. Hb levels were lower in patients with advanced epithelial ovarian cancer than in control subjects and inversely related to stage and PS. Hb negatively correlated with CRP, Fbg, interleukin 1{beta} (IL-1{beta}), IL-6, tumor necrosis factor {alpha} (TNF{alpha}), and ROS, and positively correlated with leptin and glutathione peroxidase (GPx). Multivariate regression analysis showed that stage and IL-6 were independent factors determining Hb values. This evidence suggests that anemia in epithelial ovarian cancer is common and its presence is related to stage of disease and markers of inflammation.


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