title: Elevated serum CD44 level is associated with unfavorable outcome in non-Hodgkin's lymphoma.
abstract: CD44 molecule is a cell surface glycoprotein involved in many cell-cell and cell-matrix interactions. Circulating serum CD44 (s-CD44) levels have been found to change in parallel with response to therapy, but little is known about the predictive or prognostic significance of s-CD44. In the present study, we measured s-CD44 levels in sera taken before treatment from 194 patients with non-Hodgkin's lymphoma using a chemiluminescence-enzyme immunoassay method. All except 1 patient were regularly followed-up after therapy at least for 60 months (range, 33 to 143 months). The median pretreatment s-CD44 level was 440 ng/mL (range, 13 to 1,220 ng/mL). Only 32% of the 92 patients with an International Prognostic Index (IPI) score of 0 or 1 had an s-CD44 concentration higher than the median as compared with 67% of the patients with an IPI score >/=2 (P < .0001). Patients with lower than the median s-CD44 achieved more often a complete remission to therapy (P = .0002) and had better survival (P = .007) than those with higher s-CD44 levels. However, in a multivariate analysis, only the IPI score had independent prognostic value (P < .001). The findings were similar if only the patients with diffuse large-cell lymphoma (n = 51) were included in the analysis, but among patients with low-grade lymphoma, the median s-CD44 level was not significantly associated with the IPI or survival. In conclusion, a high s-CD44 level at diagnosis is associated with a high IPI score, poor response to treatment, and unfavorable outcome in non-Hodgkin's lymphoma.
authors.affiliation: Department of Oncology, Turku University Central Hospital, National Public Health Institute, MediCity Research Laboratory, Turku University, Turku, Finland.
authors.forename: R
authors.initials: R
authors.lastname: Ristamäki
authors.forename: H
authors.initials: H
authors.lastname: Joensuu
authors.forename: K
authors.initials: K
authors.lastname: Lappalainen
authors.forename: L
authors.initials: L
authors.lastname: Teerenhovi
authors.forename: S
authors.initials: S
authors.lastname: Jalkanen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor; D005260:Female; D006801:Humans; D018960:Hyaluronan Receptors / Q000097:blood*; D007118:Immunoassay / Q000379:methods*; D008228:Lymphoma, Non-Hodgkin / Q000097:blood / Q000276:immunology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis
chemical_list: D014408:Biomarkers, Tumor; D018960:Hyaluronan Receptors