Assessment and prognostic significance of a serum cytokine panel in diffuse large B‑cell lymphoma

The objective of the present study was to assess the levels of circulating cytokines in patients with diffuse large B‑cell lymphoma (DLBCL), and to examine the associations between the cytokine levels, clinicopathological manifestations and patient prognosis. The study enrolled 49 patients with DLBCL, 11 patients with chronic lymphocytic leukemia/small lymphocytic lymphoma and 67 healthy controls from Zhejiang Provincial People's Hospital (Hangzhou, China) between January 2017 and January 2020. The serum levels of interleukin (IL)‑2, IL‑4, IL‑6, IL‑10, IL‑17, tumor necrosis factor (TNF)‑α and interferon (IFN)‑γ were measured using flow cytometry. The IL‑6, IL‑10 and IFN‑γ levels were significantly raised in patients with DLBCL compared with those in the healthy controls (P<0.05). The levels of IL‑10 were significantly higher in patients with raised levels of circulating lactate dehydrogenase (P<0.05), while increases in both IL‑6 and IL‑10 were associated with raised C‑reactive protein (CRP) levels, with IL‑6 levels positively associated with those of serum CRP (P<0.01; r=0.66). Additionally, International Prognostic Index (IPI) risk stratification of patients with DLBCL was strongly associated with circulating IL‑6 and IL‑10 levels. Raised IL‑6, IL‑10 and TNF‑α levels were linked with worse short‑term treatment efficacies (P<0.05). Moreover, the accuracy of the model predicting short‑term treatment response in patients with DLBCL, obtained using the support vector machine algorithm, was 81.63%. It was also found that raised serum IL‑6 and IL‑10 levels, together with reduced levels of IL‑17, were associated with survival of <1 year in patients with DLBCL (P<0.05), although no significant link was found between cytokine levels and long‑term overall survival. In conclusion, the serum levels of IL‑6, IL‑10, IL‑17, TNF‑α and IFN‑γ can potentially serve as biological indicators of DLBCL tumor immune status, and combined application with the IPI score can be a robust prognostic indicator in patients with DLBCL.