Serum nm23-H1 protein as a prognostic factor in aggressive non-Hodgkin lymphoma.
Advances in chemotherapy have led to a favorable long-term prognosis in approximately 50% of patients with aggressive non-Hodgkin lymphoma (NHL). However, the remaining patients do not enjoy such prolonged survival after standard treatment. New prognostic factors are needed to define this poor-prognosis group and to plan an appropriate treatment strategy. It has been reported that serum nm23-H1 protein may be a new prognostic factor for aggressive NHL. In the present study involving multiple institutions and a large number of patients, the level of nm23-H1 protein was compared among different types of lymphoma; it was lowest for indolent lymphoma, followed by aggressive lymphoma and then highly aggressive lymphoma. In addition, patients with aggressive NHL and higher nm23-H1 levels had worse overall and progression-free survival rates than those with lower nm23-H1 levels. The nm23-H1 level was also compared between patients with diffuse large B-cell lymphoma and patients with peripheral T-cell lymphoma. The results suggest that the level of nm23-H1 could serve as a prognostic factor in both groups. Moreover, the prognosis of lymphoma patients could be ascertained even more precisely by combining soluble interleukin-2 receptor or soluble CD44 and nm23-H1 levels. A multivariate analysis confirmed that the nm23-H1 level is an independent and important prognostic factor in aggressive NHL. Therefore, it may provide useful information for clinicians to determine the appropriate therapy for each type of lymphoma.
First Department of Internal Medicine, Toho University School of Medicine, Tokyo; Research Institute, Saitama Cancer Center, Saitama. nniitsu@med.kitasato-u.ac.jp
N
N
Niitsu
J
J
Okabe-Kado
M
M
Okamoto
T
T
Takagi
T
T
Yoshida
S
S
Aoki
M
M
Hirano
Y
Y
Honma
D000206:Actuarial Analysis; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000097:blood; D015415:Biomarkers / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D005615:Freezing; D006801:Humans; D018960:Hyaluronan Receptors / Q000097:blood; D008228:Lymphoma, Non-Hodgkin / Q000097:blood / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D020559:Monomeric GTP-Binding Proteins / Q000097:blood*; D054778:NM23 Nucleoside Diphosphate Kinases; D009701:Nucleoside-Diphosphate Kinase; D011379:Prognosis; D015375:Receptors, Interleukin-2 / Q000097:blood; D015996:Survival Rate; D014157:Transcription Factors / Q000097:blood*
D000951:Antigens, Neoplasm; D015415:Biomarkers; D018960:Hyaluronan Receptors; D054778:NM23 Nucleoside Diphosphate Kinases; D015375:Receptors, Interleukin-2; D014157:Transcription Factors; C517938:NME1 protein, human; D009701:Nucleoside-Diphosphate Kinase; D020559:Monomeric GTP-Binding Proteins