Impaired production of interleukin 6 and tumour necrosis factor alpha in whole blood cell cultures of patients with multiple myeloma

Cytokine production in whole blood cell cultures can be an indicator of imm une cellular status in neoplastic patients. Production of interleukin 6 (IL -6) and tumour necrosis factor alpha (TNF-alpha) after stimulation with lip opolysaccharide was measured in 1/10 diluted whole blood culture of patient s with monoclonal gammopathies [monoclonal gammopathy of undetermined signi ficance (MGUS) and multiple myeloma (MM)]. With this system, lower producti on of IL-6 and TNF-alpha at 4, 24 and 48 h in total blood cultures in patie nts with symptomatic MM was observed. Thus, the capacity of cytokine produc tion was greater in control subjects and in patients with MGUS and MM in re sponse than in symptomatic MM (P = 0.005 at 4 h and P = 0.006 at 24 and 48 h for IL-6 and P < 0.0001 at 24 h and P < 0.001 at 48 h for TNF-alpha). The se differences remained significant after adjustment on the basis of the ly mphocyte count (P < 0.001 for IL-6 and TNF-alpha at 24 and 48 h). The impai red IL-6 and TNF-alpha production in patients with symptomatic MM is probab ly due to a tumour-related immunosuppressive status. (C) 1998 Academic Pres s.