A systematic review of the association between immunogenomic markers and cancer-related fatigue

Brain Behav Immun. 2012 Aug;26(6):830-48. doi: 10.1016/j.bbi.2012.05.004. Epub 2012 May 14.


Fatigue, which is one of the most commonly reported symptoms in cancer, can negatively impact the functional status and the health-related quality of life of individuals. This paper systematically reviews 34 studies to determine patterns of associations between immunogenomic markers and levels of cancer-related fatigue (CRF). Findings from the longitudinal studies revealed that elevated fatigue symptoms especially of women with early stages of breast cancer were associated with high levels of neutrophil/monocyte, IL-1ra, and IL-6 during radiation therapy; high levels of CD4+, IL-1β, and IL-6 with stressing stimuli; high levels of IL-1β during chemotherapy; low NK cell levels after chemotherapy; and presence of homozygous IL-6 and TNF alleles. In the cross-sectional studies, associations between levels of fatigue and immune/inflammatory markers were not consistently found, especially when covariates such as BMI, ethnicity, menopausal status, and educational level were controlled in the statistical analyses. However, a number of genomic markers were observed to be elevated mostly in fatigued breast cancer survivors in the cross-sectional studies. Gaps in knowledge and recommendations for future research are discussed.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Biomarkers / blood*
  • Breast Neoplasms / complications
  • Breast Neoplasms / genetics
  • Breast Neoplasms / immunology
  • C-Reactive Protein / analysis
  • CD4-Positive T-Lymphocytes / physiology
  • Cross-Sectional Studies
  • Cytokines / blood
  • Fatigue / etiology
  • Fatigue / genetics*
  • Fatigue / immunology*
  • Female
  • Genetic Markers / immunology*
  • Genomics*
  • Humans
  • Longitudinal Studies
  • Neoplasms / complications
  • Neoplasms / genetics*
  • Neoplasms / immunology*
  • Risk Factors
  • Survivors


  • Biomarkers
  • Cytokines
  • Genetic Markers
  • C-Reactive Protein