Biological markers may add to prediction of outcome achieved by International Prognostic Score in Hodgkin's disease

Department of Medicine, Karolinska Hospital and Institutet, Stockholm, Sweden.
Annals of Oncology (Impact Factor: 7.04). 12/2000; 11(11):1405-11. DOI: 10.1023/A:1026551727795
Source: PubMed


The International Prognostic Score (IPS) identifies seven independent factors predicting progression-free and overall survival in advanced stage Hodgkin's disease (HD). The IPS is also applicable in limited disease. However, the IPS does not identify patients with a very poor prognosis. The aim of this study was to define biological markers which may add to the IPS in predicting outcome.
One hundred forty-five patients (> 15 years) with HD of all stages and histopathology subgroups were included. In addition to factors included in the IPS, serum levels of CRP, sCD4, sCD8, sCD25, sCD30, sCD54, interleukin (IL)-10, beta2-microglobulin and thymidine kinase were analysed.
The strongest predictors of a poor cause-specific survival (CSS) in univariate analyses were: increased serum levels of IL-10, sCD30 and CRP, anaemia, low levels of albumin (P < 0.001); stage IV (P = 0.003), age > or = 45 years (P = 0.006), increased serum levels of sCD25 (P = 0.010), low lymphocyte counts (P = 0.020). Serum IL-10 added prognostic information to that achieved by the IPS: patients with a high score and increased serum IL-10 had a very poor outcome with a five-year CSS of 38%. Patients with increased serum levels of sCD30 and a high score also had a poor outcome with a five-year CSS of 54%.
Serum levels of IL-10 and sCD30 may add to IPS in prediction of outcome in HD, and should be validated in large, prospective studies.

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    • "To our knowledge, prognostic significances of EBI3, IL27, or IL35 have not been investigated. In contrast, another EBVinduced cytokine, IL10, has been identified repeatedly as prognostic factor for HL[107,119,137138139140141142. The association between poor prognosis and high levels of IL10 might indicate that the immunosuppressive activity of IL10 (and probably EBI3) is required for immune escape of HL cells. "
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    • "Elevated serum IL-10 levels have been found in up to 50% of HL patients and have been associated with inferior failure free survival (FFS) and overall survival (OS) in patients treated with ABVD or BEACOPP chemotherapy (Rautert et al., 2008; Sarris et al., 1999; Vassilakopoulos et al., 2001; Viviani et al., 2000). Elevated serum IL-10 levels confer a poor survival and may add to the prognostic value of the IPS in prediction of outcomes in HL (Axdorph et al., 2000). CCL17/TARC is a chemokine secreted by H/RS cells and its chemotactic properties may explain the infiltration of reactive T lymphocytes in HL (Niens et al., 2008; Peh et al., 2001; van den Berg et al., 1999). "

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    • "The relative tumour burden obtained from radiologically measurable tumour burden normalized to body surface area is also promising (Gobbi, 2002). Soluble CD30 might also correlate with the number of HRS cells and correlates with prognosis (Axdorph et al., 2000; Christiansen et al., 1995; Enblad G, 1997; Nadali et al., 1998; Nadali et al., 1994). Different factors reflecting the growth characteristics of the HRS cells are prognostic factors (Zander et al., 2002). "
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