title: Serum interleukin-18 level is associated with the outcome of patients with diffuse large B-cell lymphoma treated with CHOP or R-CHOP regimens.
abstract: BACKGROUND
  We have previously reported that serum interleukin-18 (IL-18) concentration predicted the clinical outcome of patients with aggressive non-Hodgkin's lymphoma treated with cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP). When rituximab (R) was added to this regimen, the prognosis of diffuse large B-cell lymphoma (DLBCL) was markedly improved.
  
  
  METHODS
  In this study, we re-evaluated the prognostic significance of serum IL-18 in 227 DLBCL patients. Seventy-three patients received CHOP before R-era, and 154 patients received rituximab-cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) recently.
  
  
  RESULTS
  Four-year overall survival (4-yr OS) rates for patients in CHOP group with IL-18 ≥720 pg/mL and <720 pg/mL were 8.2% and 67.3% (P<0.0001), respectively, and 4-yr OS rates with IL-18 ≥590 and <590 pg/mL in R-CHOP group were 53.4% and 77.8% (P=0.0008), respectively. Multivariate analysis revealed that serum IL-18 correlated most significantly with OS and progression-free survival (PFS) in both groups (OS: P<0.0001, PFS: P<0.0001, in CHOP group; OS: P=0.0147, PFS: P=0.0084 in R-CHOP group). The high serum IL-18 patients with poor prognostic group in revised IPI or with non-germinal center B-cell phenotype had a very poor prognosis.
  
  
  CONCLUSIONS
  Serum IL-18 might be a powerful prognostic factor for DLBCL in R-era.
authors.affiliation: First Department of Internal Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagi-do, Gifu, Japan.
authors.forename: Naoe
authors.initials: N
authors.lastname: Goto
authors.forename: Hisashi
authors.initials: H
authors.lastname: Tsurumi
authors.forename: Senji
authors.initials: S
authors.lastname: Kasahara
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Kanemura
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hara
authors.forename: Ichiro
authors.initials: I
authors.lastname: Yasuda
authors.forename: Masahito
authors.initials: M
authors.lastname: Shimizu
authors.forename: Nobuo
authors.initials: N
authors.lastname: Murakami
authors.forename: Michio
authors.initials: M
authors.lastname: Sawada
authors.forename: Toshiki
authors.initials: T
authors.lastname: Yamada
authors.forename: Masao
authors.initials: M
authors.lastname: Takemura
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Seishima
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kito
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Takami
authors.forename: Hisataka
authors.initials: H
authors.lastname: Moriwaki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D020382:Interleukin-18 / Q000097:blood*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D011379:Prognosis; D000069283:Rituximab; D016019:Survival Analysis; D014750:Vincristine / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D020382:Interleukin-18; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone