Abstract # 3080 Tocilizumab, an IL-6 Receptor antagonist, is associated with worse depression, anxiety, pain, and sleep following hematopoietic cell transplantation

Sickness symptoms associated with immunomodulatory treatments for cancer provided some of the first evidence for the neural and behavioral actions of cytokines. We now see a reemergence of this clinical relevance in the context of new therapeutic modalities targeting different aspects of immunity, including the IL-6 receptor antagonist tocilizumab. We hypothesized that tocilizumab would decrease depression, anxiety, fatigue, sleep disturbance, and pain in individuals undergoing allogeneic hematopoietic cell transplantation (HCT). This clinical trial compared outcomes from 25 patients receiving pre-HCT tocilizumab to an historical control group of 63 HCT patients. Participants completed self-report measures pre-HCT, day + 28 (D + 28), D + 100, and D + 180 post-transplant. A linear mixed-effect model co-varying for baseline variables evaluated the effects of tocilizumab on depression, anxiety, fatigue, sleep, and pain. The tocilizumab-exposed group had significantly higher depression scores at D + 28 (p = .02), more anxiety at all time points (p