Use of serum soluble interleukin-2 receptor levels to monitor the progression of cutaneous T-cell lymphoma.
BACKGROUND
The serum concentration of soluble alpha chain of the interleukin-2 receptor (sIL-2R) correlates with tumor burden in cutaneous T-cell lymphoma (CTCL). Therefore the sIL-2R level may be useful to monitor the condition of patients treated with extracorporeal photopheresis or other treatments.


OBJECTIVE
Our goal was to determine the utility of serum sIL-2R as a test in monitoring of patients with advanced CTCL.


METHODS
Serum sIL-2R was measured serially in 36 patients with advanced CTCL treated with extracorporeal photopheresis and other modalities (interferon alfa, methotrexate, topical nitrogen mustard, electron beam).


RESULTS
Serum concentrations of sIL-2R as well as lactate dehydrogenase (LDH) correlated strongly with lymph node size, but only sIL-2R correlated significantly with the severity of skin manifestations in erythrodermic patients. In addition, serum sIL-2R, but not LDH, was significantly higher in patients with nodal involvement. The level of sIL-2R also was significantly higher in patients with large-cell transformation in the skin or lymph nodes compared with patients without transformed disease. During treatment, serum concentrations of both serum sIL-2R and LDH correlated with changes in clinical status, but only sIL-2R showed statistically significant differences in mean levels for different relative global response scores. Pretreatment levels of both sIL-2R and LDH correlated significantly with survival, but only sIL-2R retained significance when both were entered into the Cox proportionate hazards model.


CONCLUSIONS
The concentration of serum sIL-2R correlates well with disease status and is more useful than LDH or Sézary cell counts to monitor clinical change in patients with advanced CTCL. Moreover, our data suggest that sIL-2R is produced at a relatively low rate by tissue-based lymphoma cells, and that large-cell transformation in CTCL results in marked increase in sIL-2R production in some patients.
Vonderheid
E C
EC
Department of Dermatology, School of Public Health, Allegheny University of the Health Sciences, Philadelphia, PA 19102, USA.
Zhang
Q
Q
Lessin
S R
SR
Polansky
M
M
Abrams
J T
JT
Bigler
R D
RD
Wasik
M A
MA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D018450:Disease Progression; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D016410:Lymphoma, T-Cell, Cutaneous / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D017893:Photopheresis; D015375:Receptors, Interleukin-2 / Q000097:blood*; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy
D014408:Biomarkers, Tumor; D015375:Receptors, Interleukin-2; D007770:L-Lactate Dehydrogenase