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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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Submitted January 12, 2005
Accepted March 10, 2005
Hemoglobin levels correlate with interleukin-6 levels in patients with advanced untreated epithelial ovarian cancer: Role of inflammation in cancer-related anemia
Antonio Maccio*, Clelia Madeddu, Daniela Massa, Maria C Mudu, Maria R Lusso, Giulia Gramignano, Roberto Serpe, Gian Benedetto Melis, and Giovanni Mantovani
Department of Obstetrics and Gynecology, Sirai Hospital, Carbonia, Italy
Department of Medical Oncology, University of Cagliari, Cagliari, Italy
Department of Obstetrics and Gynecology, University of Cagliari, Cagliari, Italy
* Corresponding author; email: clelia_md{at}yahoo.it.
Anemia occurs in more than 30% of epithelial ovarian cancer patients 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 advanced epithelial ovarian cancer patients in order 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 epithelial ovarian cancer patients and 95 age-weight/height matched healthy women, 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 advanced epithelial ovarian cancer patients than in controls and were inversely related with stage and PS. Hb negatively correlated with CRP, Fbg, IL-1 , IL-6, TNF and ROS, and positively correlated with leptin and GPx. Multivariate regression analysis showed that stage and IL-6 levels 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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