title: Prognostic value of soluble interleukin 2 receptor levels in Langerhans cell histiocytosis.
abstract: We investigated the prognostic significance of soluble interleukin 2 receptor (sIL-2r) levels in the pre- and post-treatment serum of paediatric patients with Langerhans cell histiocytosis (LCH). Serum levels of sIL-2r from 32 LCH patients and 14 healthy controls were determined using enzyme-linked immunosorbent assay. The LCH patients were classified, evaluated and treated according to the Histiocyte Society's protocols. The following clinical stages were considered: single-system disease (A) divided into single-site (A1; n=4), multiple-site (A2; n=9), and multisystem disease (B) without organ dysfunction (B1; n=5) and with organ dysfunction (B2; n=14). Pretreatment concentrations of sIL-2r were markedly increased at diagnosis in LCH patients compared with controls [in pg/ml, median (range) 9200 (1124-40000) versus 610 (343-800)], P < 0.0001. Levels differed significantly between stages A [3250 (1124-11000)] and B [22750 (3400-40000)], P < 0.05, and between substages A2 and B2, P < 0.05. There was a significant correlation between clinical stages and sIL-2r serum levels, r=0.7996 (P < 0.0001). Patients with > or = 17500 pg/ml of sIL-2r had a 30-month survival of 0.417 (SEM: 0.142) compared with those with levels < 17500 pg/ml, who presented a 30-month survival of 0.848 (SEM: 0.100) (log-rank, P < 0.0001). In multivariate analysis, sIL-2r levels > or = 17500 pg/ml were found to have greater predictive strength than other well-known prognostic factors.
authors.affiliation: Department of Hematology/Oncology and Department of Immunology, Hospital de Pediatría SAMIC Prof Dr Juan P Garrahan, Buenos Aires, Argentina. drosso@intramed.net.ar
authors.forename: Diego A
authors.initials: DA
authors.lastname: Rosso
authors.forename: Adriana
authors.initials: A
authors.lastname: Roy
authors.forename: Marta
authors.initials: M
authors.lastname: Zelazko
authors.forename: Jorge L
authors.initials: JL
authors.lastname: Braier
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006646:Histiocytosis, Langerhans-Cell / Q000097:blood* / Q000188:drug therapy / Q000401:mortality; D006801:Humans; D007223:Infant; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D015375:Receptors, Interleukin-2 / Q000097:blood*; D012044:Regression Analysis; D018709:Statistics, Nonparametric; D015996:Survival Rate
chemical_list: D015375:Receptors, Interleukin-2