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Evidence of Associations Between Cytokine Gene Polymorphisms and Quality of Life in Patients With Cancer and Their Family Caregivers

Kimberly Alexander

Bruce A. Cooper

Steven M. Paul

Claudia M. West

Patsy Yates

Kord M. Kober

Bradley E. Aouizerat

Christine Miaskowski

quality of life, cytokines, genetics, growth mixture modeling, family caregivers, radiation therapy
ONF 2014, 41(5), E267-E281. DOI: 10.1188/14.ONF.E267-E281

Purpose/Objectives: To identify latent classes of individuals with distinct quality-of-life (QOL) trajectories, to evaluate for differences in demographic characteristics between the latent classes, and to evaluate for variations in pro- and anti-inflammatory cytokine genes between the latent classes.

Design: Descriptive, longitudinal study.

Setting: Two radiation therapy departments located in a comprehensive cancer center and a community-based oncology program in northern California.

Sample: 168 outpatients with prostate, breast, brain, or lung cancer and 85 of their family caregivers (FCs).

Methods: Growth mixture modeling (GMM) was employed to identify latent classes of individuals based on QOL scores measured prior to, during, and for four months following completion of radiation therapy. Single nucleotide polymorphisms (SNPs) and haplotypes in 16 candidate cytokine genes were tested between the latent classes. Logistic regression was used to evaluate the relationships among genotypic and phenotypic characteristics and QOL GMM group membership.

Main Research Variables: QOL latent class membership and variations in cytokine genes.

Findings: Two latent QOL classes were found: higher and lower. Patients and FCs who were younger, identified with an ethnic minority group, had poorer functional status, or had children living at home were more likely to belong to the lower QOL class. After controlling for significant covariates, between-group differences were found in SNPs in interleukin 1 receptor 2 (IL1R2) and nuclear factor kappa beta 2 (NFKB2). For IL1R2, carrying one or two doses of the rare C allele was associated with decreased odds of belonging to the lower QOL class. For NFKB2, carriers with two doses of the rare G allele were more likely to belong to the lower QOL class.

Conclusions: Unique genetic markers in cytokine genes may partially explain interindividual variability in QOL.

Implications for Nursing: Determination of high-risk characteristics and unique genetic markers would allow for earlier identification of patients with cancer and FCs at higher risk for poorer QOL. Knowledge of these risk factors could assist in the development of more targeted clinical or supportive care interventions for those identified.

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