Expression and correlation of IL-2, IL-10 and TNF-α in patients with multiple myeloma-infected herpes zoster treated by bortezomib-containing regimen

Background: Multiple myeloma (MM) is a proliferative disease with complex pathogenesis. Most patients will have low body resistance and high inflammatory mediators. Bortezomib is an anti-tumor drug. There are few reports on the clinical efficacy and adverse reactions of bortezomib intervention. This research aimed to explore the effect of bortezomib on inflammation and immune lymphocytes of patients with MM-infected herpes zoster.

Objective: The aim of this study is to explore the effect of bortezomib on inflammation and immune lymphocytes, i.e. the expression and correlation of interleukin (IL)-2, IL-10 and tumor necrosis factor-α (TNF-α) in patients with MM-infected herpes zoster (HZ) receiving bortezomib-containing regimen.

Methods: From October 2017 to March 2020, 83 MM patients receiving bortezomib-containing regimen were analyzed retrospectively, patients were divided into infection group (28 cases, IG) and non-infection group (55 cases, NG) based on whether or not they are complicated with HZ Pre- and post-treatment. IL-2, IL-10, TNF-α and immune lymphocytes (CD3⁺, CD4⁺, CD8⁺) were tested by AimPlex multifactor flow detection technique, and the Eastern Cooperative Oncology Group (ECOG) performance status scores were compared before therapy. The independent risk factors of patients receiving bortezomib-containing regimen were analyzed via multivariate logistic regression.

Results: After therapy, serum IL-2 and TNF-α declined significantly in NG while changed insignificantly in IG. Compared with NG, serum CD3⁺ and CD4⁺ in IG increased after treatment, while CD8⁺ decreased significantly. Before therapy, ECOG score in IG was higher than that in NG. Correlation analysis showed that IL-2 and TNF-α were negatively correlated with CD3⁺ and CD4⁺, and positively correlated with CD8⁺ and ECOG score. IL-10 was the opposite. Multivariate logistic regression analysis identified the independence of declined CD3⁺, CD4⁺, CD8⁺ and IL-10, increased IL-2, TNF-α and ECOG score before treatment as risk factors for HZ.

Conclusion: MM patients have a high incidence of HZ. Before treatment, lymphocytopenia, increased IL-2, TNF-α and decreased IL-10 are important risk factors for HZ.