Limited usefulness of CA125 measurement in the management of Hodgkin's and non-Hodgkin's lymphoma.
BACKGROUND
Several papers have reported an association of high CA125 serum levels with advanced non-Hodgkin's lymphoma (NHL) as well as a relationship between high CA125 values and poor outcome.


METHODS
Ninety-nine patients with NHL or Hodgkin's disease (HD) underwent serum CA125 assessment at diagnosis. Gender, age, presence of B symptoms, performance status (PS), histology, sites of tumor involvement, presence of effusion, clinical stage, age-adjusted International Prognostic Index, C-reactive protein (CRP), Hb, lactate deshydrogenase (LDH) and beta2-microglobulin were evaluated for their association with serum CA125 levels. The impact of CA125 levels and other features on overall (OS) and progression-free (PFS) survival was also assessed.


RESULTS
CA125 serum levels were elevated in 34% of the patients, including 19% of patients with aggressive NHL, 45% of patients with indolent NHL, and 29% of patients with HD. Univariate analyses showed that CA125 levels correlated with poor PS, the presence of B symptoms, advanced clinical stage, abdominal, bone marrow or mediastinal involvement, presence of effusions, high aaIPI, low Hb levels and high CRP, LDH or beta2-microglobulin levels. In multivariate analysis, bone marrow involvement, the presence of effusions, and high aaIPI were all associated with high CA125 serum levels. In univariate analyses, OS and PFS were affected by age (PFS only), poor PS, B symptoms, advanced clinical stage, bone marrow or abdominal involvement (PFS only), high aaIPI, low Hb, high CRP or beta2-microglobulin levels. OS and PFS were not different in patients with normal or elevated CA125 levels. Multivariate analyses showed significantly inferior OS and PFS in patients with high beta2-microglobulin but no influence of CA125.


CONCLUSIONS
While CA125 serum level correlates significantly with a number of features associated with more aggressive disease, it does not enhance the performance of standard prognostic markers in the management of patients with NHL or HD.
Bonnet
Christophe
C
Department of Hematology, University of Liege, CHU-Sart Tilman, Liège, Belgium. cbonnet@ulg.ac.be
Beguin
Yves
Y
Fassotte
Marie-France
MF
Seidel
Laurence
L
Luyckx
Françoise
F
Fillet
Georges
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018394:CA-125 Antigen / Q000097:blood*; D005260:Female; D006689:Hodgkin Disease / Q000097:blood*; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016019:Survival Analysis
D018394:CA-125 Antigen