Potential Role of Pleural Fluid Cytokine Profile in Myelomatous Pleural Effusions

• Main Authors: Xu J, Gao L, Yan M, Wang B, Song Z, Liu H, Sun K, Nong L, Wang M, Cen X
• Format: Article
• Language: English
• Published: Dove Medical Press 2021-08-01
• Series: OncoTargets and Therapy
• Subjects: myelomatous pleural effusions; cytokine; ifn-γ; il-2; immunomodulator.
• Online Access: https://www.dovepress.com/potential-role-of-pleural-fluid-cytokine-profile-in-myelomatous-pleura-peer-reviewed-fulltext-article-OTT

Junhui Xu,1,2,* Liang Gao,1,* Miao Yan,1 Bingjie Wang,1 Zhengyang Song,1 Huihui Liu,1 Kunyan Sun,3 Lin Nong,4 Mangju Wang,1 Xinan Cen1 1Department of Hematology, Peking University First Hospital, Beijing, People’s Republic of China; 2Xiamen Cardiovascular Hospital, Xiamen University, Xiamen, People’s Republic of China; 3Department of Respiration, Peking University First Hospital, Beijing, People’s Republic of China; 4Department of Pathology, Peking University First Hospital, Beijing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Mangju Wang; Xinan CenDepartment of Hematology, Peking University First Hospital, No. 8 Xi Shi Ku Street, Xi Cheng District, Beijing, 100034, People’s Republic of ChinaTel [phone]Email [e-mail]; [e-mail]: Myelomatous pleural effusion (MPE), as a presentation of extramedullary infiltration of multiple myeloma (MM), is rare and currently associated with poor outcomes without effective therapy. The potential value of cytokine detection in pleural effusion to MPE has not been reported to date.Case Presentation: We herein report a case of refractory and relapsed multiple myeloma that developed bilateral MPE due to disease progression caused by intolerance to various chemotherapy regimens. Cytomorphology and flow cytometry were adopted for diagnosis confirmation. Chemotherapy containing immunomodulators combined with thoracic catheterization drainage was applied to the patient, showing a certain therapeutic effect. During the course of disease, the change of cytokine profile in pleural effusion was monitored by cytometric bead array (CBA) technology, revealing that cytokines related to tumor load such as interleukin 6 (IL-6) and interleukin 10 (IL-10) in pleural effusion decreased with the improvement of disease, while other cytokines such as interleukin 2 (IL-2), interleukin 4 (IL-4), interleukin 17A (IL-17A), tumor necrosis factor α (TNF-α), interferon γ (IFN-γ), granzyme A, granzyme B, perforin and granulysin increased with the improvement of disease.Conclusion: There is a prospect that cytokine level in pleural effusion may indicate treatment response of MPE, and in light of this case, immunomodulators may be utilized in treating patients suffering MPE. Due to limitations of our single case, we urge more groups to evaluate the potential role of cytokine profile in MPE.Keywords: myelomatous pleural effusions, cytokine, IFN-γ, IL-2, immunomodulator