| Abstrakt: |
In 93 newly diagnosed lymphoma patients, tumor necrosis factor alpha (TNFα) and its p55 soluble receptor (p55-sR), were prospectively determined in plasma by IRMA and ELISA methods respectively. These 93 patients included 31 patients with low grade lymphoma, 55 with intermediate or high grade lympboma and 7 with Hodgkin's disease. Median TNFα plasma values were 20pg/mL (range 5 380pg/ mL) in patients versus 7pg/mL (range 4-gpg/mL) in healthy control subjects. Presence of TNFα level equal or greater than 20 pg/mL was significantly associated with elevated LDH level, serum β2-microglobulin level ≥3 mg/L, hemoglobin ≤ 12 g/dL, Ann Arbor stage III or IV disease, and with bulky tumor. High level of TNFα was also associated, although less strongly, with B symptoms, poor performance status, and serum albumin ≤35 g/L, yet it was not associated with changes in acute phase protein levels. Levels of p55-sR were also markedly elevated in these lymphoma patients (median of 3.5 ng/mL, range 0.8 18.8 ng/ mL) versus 1.45 ng/mL in control subjects (range 1.1-2.3 ng/mL). Level of p55-sR equal or greater than 3.5 ng/mL was significantly associated with poor performance status, B symptoms, β2-microglobulin levels >3 mg/L, serum albumin ≤35g/L, C-reactive protein >6 mg/L, hemoglobin < 12g/dL, and bulky tumor. In the whole group of 93 patients, both high TNFα and p55-sR levels strongly predicted short freedom from progression and overall survival. This study suggests that elevated TNFα and p55-sR plasma levels have a high correlation with other adverse prognostic factors in lymphoma patients and predict their poor outcome. [ABSTRACT FROM AUTHOR] |
