Clinical correlates of elevated serum levels of interleukin 6 in patients with untreated Hodgkin's disease.
BACKGROUND
Interleukin-6 (IL-6) is a potent immunomodulatory cytokine that may have pathogenetic significance in several malignancies. In addition, high IL-6 levels have been associated with a poor prognosis in multiple myeloma, nonHodgkin's lymphoma, ovarian cancer, and renal cancer, as well in advanced Hodgkin's lymphoma. In this study, we analyzed IL-6 levels in newly diagnosed Hodgkin's disease and determined clinical correlates of elevated levels.


METHODS
Using a sensitive enzyme-linked immunosorbent assay (lower limit of sensitivity = 0.35 pg/mL) we measured IL-6 levels in sera from 33 healthy controls and 65 untreated patients with Hodgkin's disease.


RESULTS
Interleukin-6 levels in the Hodgkin's patients (median 2.7 pg/mL; range < 0.35 to 38.4 pg/mL) were significantly higher than in the controls (median < 0.35 pg/mL; range < 0.35 to 1.87 pg/mL; P < 0.0001). Interleukin-6 levels were also higher in males (P = 0.03) and in patients with bulky disease (P = 0.026) or advanced Ann Arbor stage (P = 0.017). In addition, serum levels of IL-6 also showed direct linear correlations with the erythrocyte sedimentation rate (r = 0.64, P = 0.0007), platelet count (r = 0.53, P < 0.0001), leukocyte count (r = 0.36, P = 0.003), and beta (2)-microglobulin level (r = 0.4, P = 0.0012); and an inverse linear correlation with serum albumin level (r = -0.43, P = 0.0003). In the 10 patients tested who had elevated serum IL-6 levels pretherapy and who achieved complete remission, serum IL-6 values decreased at the time of remission to the range found in healthy controls.


CONCLUSIONS
Our observations suggest that, in patients with Hodgkin's disease, serum levels of IL-6 are frequently elevated at diagnosis, normalize during remission, and are associated with specific disease characteristics including several adverse prognostic features.
Seymour
J F
JF
Department of Clinical Haematology and Medical Oncology, Royal Melbourne Hospital, Australia.
Talpaz
M
M
Hagemeister
F B
FB
Cabanillas
F
F
Kurzrock
R
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D001799:Blood Sedimentation; D005260:Female; D006689:Hodgkin Disease / Q000097:blood / Q000276:immunology* / Q000473:pathology; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010976:Platelet Count; D011237:Predictive Value of Tests; D011379:Prognosis; D012709:Serum Albumin / Q000378:metabolism; D001613:beta 2-Microglobulin
D015850:Interleukin-6; D012709:Serum Albumin; D001613:beta 2-Microglobulin