Can We Define A Measurable Laboratory Parameter Threshold To Initiate Cytokine Adsorption Therapy For Cancer Patients In The Intensive Care Unit?

CAN WE DEFINE A MEASURABLE LABORATORY PARAMETER THRESHOLD TO INITIATE CYTOKINE ADSORPTION THERAPY FOR CANCER PATIENTS IN THE INTENSIVE CARE UNIT?

Berkay Küçük, Metin Yarıcı, Mehmet Eren Yüksel

Etlik City Hospital, Surgical Intensive Care Unit, Ankara, Turkiye

Introduction: Cytokine Adsorption Therapy (CAT) may provide relief from cytokine storms in critically ill cancer patients in the intensive care unit. These storms aggravate acute respiratory distress syndrome (ARDS) and cause multi-organ failure, increasing morbidity and mortality. The lack of universally accepted initiation criteria for CAT poses a significant challenge for the standardization of cytokine adsorption therapy. The purpose of this study is to elucidate the optimal initiation criteria for CAT by assessing changes in cytokine levels, complete blood count (CBC), and biochemistry panels.

Methods: This study included data from PubMed and Google Scholar between the years 2000 and 2023. The analysis of studies elucidating the relationship between various biomarkers and CAT initiation was conducted.

Results: Among the parameters studied, which included white blood cell (WBC) count, ferritin, interleukin-6 (IL-6), procalcitonin, and C-reactive protein (CRP), there is evidence that IL-6 levels may serve as a reliable indicator for initiating CAT. In critically ill cancer patients, elevated IL-6 levels correlate with the severity of cytokine storms and poor clinical outcomes.

Conclusion: The lack of universally accepted cut-off or threshold values for initiation criteria highlights the critical need for additional research. CAT may improve patient outcomes, reduces ARDS and multi-organ failure in the context of severe malignant diseases by addressing complex cytokine storms. This study not only emphasizes the importance of CAT in critical care, but it also emphasizes the need for standardized criteria to optimize its application for improved patient prognosis and survival rates.

Keywords: Cancer, Cytokine Adsorption Therapy, Intensive Care Unit, Threshold

4. International Cancer Days, Sivas Cumhuriyet University, Sivas,  Turkiye. Date: 28.9.2023