Exploring Inflammation and Stress as Biological Correlates of Symptoms in Children With Advanced Cancer: A Longitudinal Feasibility Study.

Kathleen E Montgomery, Mays Basha, Leah Nyholm, Corey Smith, Gene Ananiev, Alexander Fedorov, Amita Kapoor, Roger Brown, Christian Capitini, Kristine Kwekkeboom
Author Information
  1. Kathleen E Montgomery: School of Nursing, University of Wisconsin-Madison, Madison, WI, USA. ORCID
  2. Mays Basha: School of Nursing, University of Wisconsin-Madison, Madison, WI, USA.
  3. Leah Nyholm: School of Nursing, University of Wisconsin-Madison, Madison, WI, USA.
  4. Corey Smith: Department of Medicine - Pulmonary/Critical Care, UW Health, Madison, WI, USA.
  5. Gene Ananiev: Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
  6. Alexander Fedorov: Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
  7. Amita Kapoor: Wisconsin National Primate Research Center, University of Wisconsin-Madison, Madison, WI, USA.
  8. Roger Brown: School of Nursing, University of Wisconsin-Madison, Madison, WI, USA.
  9. Christian Capitini: Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. ORCID
  10. Kristine Kwekkeboom: School of Nursing, University of Wisconsin-Madison, Madison, WI, USA.

Abstract

Few studies have examined biomarkers of stress and Inflammation as underlying mechanisms of symptoms in adolescents and young adults with cancer. This study determined the feasibility of collecting blood and saliva samples across time, described the range and distribution of biomarkers, and explored the association of biomarkers with symptom adverse events (AEs). This longitudinal, prospective repeated-measures single-site feasibility study recruited ������=������10 children ( = 12.5 years) receiving treatment for advanced cancer. Symptom AE data and Inflammation (cytokines and C-reactive protein) and physiologic response to stress (salivary cortisol and salivary alpha-amylase) biomarker levels were collected at three time points. Descriptive statistics were used to examine feasibility and acceptability and to summarize symptom AE, stress, and inflammatory biomarker data. A linear regression model was used to determine cortisol diurnal slopes. The relationship between symptom and inflammatory biomarker data was explored and Hedges's statistic was used to determine its effect size. Participants provided 83% of saliva samples (������=������199/240) and 185 samples were sufficient to be analyzed. Nurses collected 97% (������=������29/30) of blood samples. Participants reported the saliva collection instructions, kits, and reminders were clear and helpful. Insomnia, pain, fatigue, and anxiety demonstrated the most medium and large negative effects with inflammatory markers. Symptom AEs demonstrated the highest number of medium and large negative effects with interleukin-8 and tumor necrosis factor-alpha (-0.53 to -2.00). The results indicate longitudinal concurrent collection of symptom and biomarker data is feasible and inflammatory and stress biomarkers merit consideration for inclusion in future studies.

Keywords

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Grants

  1. P30 CA014520/NCI NIH HHS
  2. P51 OD011106/NIH HHS
  3. UL1 TR002373/NCATS NIH HHS

MeSH Term

Humans
Child
Neoplasms
Longitudinal Studies
Inflammation
Male
Feasibility Studies
Female
Adolescent
Saliva
Stress, Psychological
Biomarkers
Prospective Studies
Hydrocortisone

Chemicals

Biomarkers
Hydrocortisone

Word Cloud

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