Serum-soluble interleukin-2 receptor (sIL-2R) level determines clinical outcome in patients with aggressive non-Hodgkin's lymphoma: in combination with the International Prognostic Index
Serum-soluble interleukin-2 receptor (sIL-2R) level determines clinical outcome in patients with aggressive non-Hodgkin's lymphoma: in combination with the International Prognostic Index
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DOI：
10.1007/s00432-004-0600-9
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发表时间：
2005-02-01
影响因子：
3.6
通讯作者：
Moriwaki, H
中科院分区：
文献类型：
--
作者：
Goto, H;Tsurumi, H;Moriwaki, H
目的：本研究的目的是评估血清可溶性白介素-2受体（sIL-2R）在侵袭性非霍奇金淋巴瘤（NHL）中的预后意义。方法：在1995年至2001年期间，连续113例未经治疗的侵袭性NHL患者（弥漫性大b细胞淋巴瘤96例；外周t细胞淋巴瘤17例）前瞻性参与了这项研究。患者接受6-8个周期的CHOP或THP（吡柔比星）-COP方案治疗。结果：发病时高血清sIL-2R水平（2000 U/ml及以上）与低完全缓解率相关。高sIL-2R患者的5年生存率（24%）明显低于低sIL-2R患者（低于2000 U/ml） （74%） （P < 0.01）。采用sIL-2R水平和常规预后因素的多变量分析表明，高sIL-2R、b症状的存在和高龄（60岁及以上）是总体生存的显著不利变量。此外，我们尝试将sIL-2R与国际预后指数（IPI）结合使用。高(H)危组和低(LI)/高（HI）危组sIL-2R高的患者生存率显著低于低(L)危组和低(LI)/ HI危组sIL-2R的患者生存率（P < 0.001）。结论：高血清sIL-2R水平预示侵袭性NHL预后不良，可能是与IPI联合使用时选择适当治疗的有用生物标志物。
Purpose: The aim of the present study was to assess the prognostic significance of serum soluble interleukin-2 receptor (sIL-2R) in aggressive non-Hodgkin's lymphoma (NHL). Methods: One hundred and thirteen consecutive patients with previously untreated aggressive NHL (diffuse large B-cell lymphoma, 96; peripheral T-cell lymphoma, 17) prospectively participated in this study between 1995 and 2001. The patients were treated with 6-8 cycles of a CHOP or THP (pirarubicin)-COP regimen. Results: A high serum sIL-2R level (2,000 U/ml and over) at onset was associated with a low complete remission rate. Patients with high sIL-2R had significantly lower survival rates (5-year, 24%) than those with low sIL-2R (under 2,000 U/ml) (74%) (P < 0.01). Multivariate analysis employing sIL-2R levels and conventional prognostic factors demonstrated that high sIL-2R, presence of B-symptoms, and advanced age (60 years and older) were significantly unfavorable variables for overall survival. In addition, we attempted to use sIL-2R in combination with the International Prognostic Index (IPI). The patients in the high (H) risk group and those with high sIL-2R in the low-intermediate (LI)/high-intermediate (HI) risk group had significantly lower survival rates than the patients in the low (L) risk group and those with low sIL-2R in the LI/HI risk group (P < 0.001). Conclusion: The results suggest that a high serum sIL-2R level predicts a poor prognosis in aggressive NHL and may be a useful biomarker for selecting appropriate treatment when used in combination with the IPI.