Biological markers may add to prediction of outcome achieved by the International Prognostic Score in Hodgkin's disease.
BACKGROUND
The International Prognostic Score (IPS) identifies seven independent factors predicting progression-free and overall survival in advanced stage Hodgkin's disease (HD). The IPS is also applicable in limited disease. However, the IPS does not identify patients with a very poor prognosis. The aim of this study was to define biological markers which may add to the IPS in predicting outcome.


METHODS
One hundred forty-five patients (> 15 years) with HD of all stages and histopathology subgroups were included. In addition to factors included in the IPS, serum levels of CRP, sCD4, sCD8, sCD25, sCD30, sCD54, interleukin (IL)-10, beta2-microglobulin and thymidine kinase were analysed.


RESULTS
The strongest predictors of a poor cause-specific survival (CSS) in univariate analyses were: increased serum levels of IL-10, sCD30 and CRP, anaemia, low levels of albumin (P < 0.001); stage IV (P = 0.003), age > or = 45 years (P = 0.006), increased serum levels of sCD25 (P = 0.010), low lymphocyte counts (P = 0.020). Serum IL-10 added prognostic information to that achieved by the IPS: patients with a high score and increased serum IL-10 had a very poor outcome with a five-year CSS of 38%. Patients with increased serum levels of sCD30 and a high score also had a poor outcome with a five-year CSS of 54%.


CONCLUSIONS
Serum levels of IL-10 and sCD30 may add to IPS in prediction of outcome in HD, and should be validated in large, prospective studies.
Axdorph
U
U
Department of Medicine, Karolinska Hospital and Institutet, Stockholm, Sweden. ulla.axdorph@ks.se
Sjöberg
J
J
Grimfors
G
G
Landgren
O
O
Porwit-MacDonald
A
A
Björkholm
M
M
D000328:Adult; D015703:Antigens, CD / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood*; D001798:Blood Proteins / Q000032:analysis; D002423:Cause of Death; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006689:Hodgkin Disease / Q000097:blood / Q000401:mortality* / Q000628:therapy; D006801:Humans; D016753:Interleukin-10 / Q000097:blood*; D017730:Ki-1 Antigen / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000097:blood*; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D012995:Solubility; D016019:Survival Analysis; D013937:Thymidine Kinase / Q000097:blood; D016896:Treatment Outcome; D001613:beta 2-Microglobulin / Q000032:analysis
D015703:Antigens, CD; D014408:Biomarkers, Tumor; D001798:Blood Proteins; D017730:Ki-1 Antigen; D009363:Neoplasm Proteins; D001613:beta 2-Microglobulin; D016753:Interleukin-10; D013937:Thymidine Kinase