title: Soluble intercellular adhesion molecule-1 (s-ICAM-1/s-CD54) in diffuse large B-cell lymphoma: association with clinical characteristics and outcome.
abstract: BACKGROUND
  High serum levels of soluble intercellular adhesion molecule-1(s-ICAM-1/s-CD54) have been associated with adverse clinical features and poor outcome in chronic lymphocytic leukemia, Hodgkin's disease and non-Hodgkin's lymphoma, but their value in the different subtypes of non-Hodgkin's lymphoma has not been well addressed.
  
  
  METHODS
  Our aim was to study the serum levels of s-ICAM-1 in diffuse large B-cell lymphoma (DLBCL) and to correlate them with clinical characteristics and outcome. We analyzed the serum levels of s-ICAM-1 in a series of 55 patients with DLBCL diagnosed in a single institution. s-ICAM-1 levels were quantified by an immunoenzymatic assay. Median age was 62 years (range 22-96); 29 (53%) were male. Twenty-eight (51%) presented with advanced clinical stage (III/IV), 32 (58%) had extranodal involvement, 28 (51%) had high serum lactate dehydrogenase (LDH) and 23 (43%) had high beta2-microglobulin levels. All patients received anthracycline-containing regimens. Correlation between clinical variables and s-ICAM-1 levels were tested with the Mann-Whitney U-test and survival was plotted by the Kaplan-Meier method, and curves compared with the log-rank test.
  
  
  RESULTS
  Serum levels of s-ICAM-1 were significantly increased in patients with DLBCL compared with normal controls (589 +/- 487 versus 279 +/- 65 ng/ml, respectively; P <0.001). Higher levels of s-ICAM-1 were present in patients with B symptoms, advanced stage and increased LDH and beta2-microglobulin. s-ICAM-1 levels also correlated with achievement of a complete response. Patients with s-ICAM-1 over 668 ng/ml had a shorter time to treatment failure (TTF) (3-year TTF, 59% versus 20%, respectively; P = 0.01) and overall survival (OS) (3-year OS, 58% versus 22%, respectively; P = 0.04) than the remainders. When only low and low-intermediate risk patients in the international prognostic index score were considered, those with s-ICAM-1 over 668 ng/ml also had worse TTF and OS.
  
  
  CONCLUSIONS
  In DLBCL, s-ICAM-1 levels correlated with high tumor burden and lymphoma dissemination and may contribute to assessment of prognosis.
authors.affiliation: Department of Hematology and Medical Oncology, Hospital Clínico Universitario, University of Valencia, Valencia, Spain. terol39@mail.ono.es
authors.forename: M J
authors.initials: MJ
authors.lastname: Terol
authors.forename: M
authors.initials: M
authors.lastname: Tormo
authors.forename: J A
authors.initials: JA
authors.lastname: Martinez-Climent
authors.forename: I
authors.initials: I
authors.lastname: Marugan
authors.forename: I
authors.initials: I
authors.lastname: Benet
authors.forename: A
authors.initials: A
authors.lastname: Ferrandez
authors.forename: A
authors.initials: A
authors.lastname: Teruel
authors.forename: R
authors.initials: R
authors.lastname: Ferrer
authors.forename: J
authors.initials: J
authors.lastname: García-Conde
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000032:analysis*; D016022:Case-Control Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood*; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008207:Lymphatic Metastasis; D016393:Lymphoma, B-Cell / Q000473:pathology* / Q000628:therapy; D016403:Lymphoma, Large B-Cell, Diffuse / Q000473:pathology* / Q000628:therapy; D008228:Lymphoma, Non-Hodgkin / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D018799:Intercellular Adhesion Molecule-1; D007770:L-Lactate Dehydrogenase