ABSTRACT Chronic inflammation has been observed in patients with cancer, suggesting a possible alteration of the cytokine signaling pathway. The present study aims to identify potential cytokine markers in pediatric patients with acute lymphoblastic leukemia (ALL) classified as Pre-B, Pro-B, T and Bi phenotype. A total of 75 pediatric patients diagnosed with ALL were included in the present study, and divided into Pre-B, Pro-B, B, T and Bi phenotype groups. To determine the concentration of 13 cytokines and chemokines, 2 ml peripheral blood was collected by venipuncture. As a control, serum samples were obtained from 48 pediatric patients without a malignant, an infectious or immunological disease. Cytokine and chemokine levels in the serum from patients and control were quantified by multiplex analyte technology using the Millipore HCYTOMAG-60K kit. Analysis for the identification of potential biomarkers was performed using the PanelomiX software. The results revealed that interleukin-10 (IL-10) was the best biomarker in all immunophenotypes. Furthermore, other cytokines and chemokines, such as transforming growth factor β (TGF-β), interleukin-8 (IL-8), and tumor necrosis factor α (TNF-α), were detected in the Pre-B and Pro-B phenotypes. In the T phenotype, TNF-α and interferon-γ were detected as biomarkers in addition to IL-10. In the biphasic IL-10 phenotype, TNF-α and TGF-β were identified as biomarkers. The upregulation of cytokines suggests a phenomenon identified as ‘cytokine release syndrome’, which is a systemic inflammatory state described in infectious diseases, autoimmune diseases, and certain types of leukemia and lymphoma. The present study identified specific markers in each of the leukemic phenotypes studied, and provided a basis for the possibility of structuring chemotherapy more specifically to regulate cytokine expression, and to achieve the recovery of homeostasis.
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