Plasma Cytokine and Soluble Receptor Signature Predicts Outcome of Patients With Classical Hodgkin's Lymphoma: A Study From the Groupe d'Etude des Lymphomes de l'Adulte
| Autor: | Jean-Yves Blay, Josette Brière, Monique Grandjean, Franck Morschhauser, Pierre Lederlin, Christophe Fermé, Jean Gabarre, Nicolas Mounier, Jacques Bienvenu, Gilles Salles, Marine Divine, Aspasia Stamatoullas, Michel Guiguet, Pauline Brice, Rene-Olivier Casasnovas, Laurent Voillat, Liliane Intrator |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Cancer Research medicine.medical_specialty Adolescent medicine.medical_treatment Gastroenterology Soluble cd30 Internal medicine Blood plasma medicine Humans Prospective Studies Receptors Cytokine Receptor Aged Aged 80 and over business.industry Plasma levels Middle Aged medicine.disease Hodgkin Disease Survival Analysis Classical Hodgkin's Lymphoma Lymphoma Treatment Outcome Endocrinology Cytokine Oncology Multivariate Analysis Cytokines Tumor necrosis factor alpha business |
| Zdroj: | Journal of Clinical Oncology. 25:1732-1740 |
| ISSN: | 1527-7755 0732-183X |
| DOI: | 10.1200/jco.2006.08.1331 |
| Popis: | Purpose Approximately 15% of patients with localized and 30% with disseminated classical Hodgkin's lymphoma fail to respond or relapse after first-line treatment. Usual prognosis scoring systems are actually unable to identify this small subset of patients with good confidence, pointing out the need for additional prognostic biomarkers. Patients and Methods We prospectively analyzed the prognosis value of plasma levels of tumor necrosis factor (TNF), its soluble receptors TNF-R1 and TNF-R2, IL-10, IL1-RA, IL-6, and soluble CD30 (sCD30) when taken before any treatment in 519 consecutive patients with a first diagnosis of classical Hodgkin's lymphoma. Results Levels of TNFα higher than 46 pg/mL, TNF-R1 higher than 3 ng/mL, TNF-R2 higher than 5 ng/mL, IL-10 higher than 30 pg/mL, IL1-RA higher than 668 pg/mL, IL-6 higher than 30 pg/mL, and sCD30 higher than 80 U/mL were associated with poor event-free and overall survival. In multivariate analysis, high levels of IL1-RA, IL-6, and sCD30 were independent poor prognosis factors, and the cytokine signature based on their combination allowed the stratification of patients in four prognosis classes, reaching a 5-year event-free survival probability of 92%, 85%, 76%, and 15%, respectively. This index was more potent than other scoring systems to predict patient event-free survival, and remained independent from the international prognostic score (P < .001), adding significant prognostic information to its predictive power. Conclusion Plasma cytokine signature is sufficient to predict disease-related outcome in classical Hodgkin's lymphoma, and allows the identification of patients with very high risk of treatment failure. |
| Databáze: | OpenAIRE |
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