title: Soluble interleukin-2 receptor level predicts survival in patients with follicular lymphoma treated with cyclophosphamide, doxorubicin, vincristine and prednisone chemotherapy in the rituximab era.
abstract: This study analyzed the prognostic significance of soluble interleukin-2 receptor α (sIL-2Rα) levels in 100 prospectively enrolled patients with previously untreated follicular lymphoma. It showed that sIL-2Rα level ≥ 115 pmol/L at the time of treatment initiation correlated with a high Follicular Lymphoma International Prognostic Index-2 (FLIPI-2), bulky disease, advanced clinical stage, number of involved lymph nodes, bone marrow involvement and elevated β2-microglobulin (B2M) level. When testing all patients, sIL-2Rα ≥ 115 pmol/L was associated with significantly shorter progression-free (PFS; p < 0.03, hazard ratio [HR] 2.04) but not overall (OS; p = 0.06, HR 2.36) survival rates. Subanalysis of patients receiving cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) ± rituximab showed higher predictive power for both PFS (HR 2.75, 95% confidence interval [CI] 1.24-6.11, p = 0.01) and OS (HR 3.33, 95% CI 1.15-9.63, p = 0.02). In the whole population (n = 100), only B2M proved a significant univariate predictor (p = 0.007, HR = 2.8) of PFS. When testing patients treated with CHOP ± rituximab, sIL-2Rα was found to be the best univariate predictor for PFS among all FLIPI-2 factors (HR = 2.68, p = 0.015). Serum IL-2Rα levels may help to refine risk assessment in the modern immunotherapy era complementary to FLIPI-2 factors.
authors.affiliation: Department of Hemato-Oncology, Palacky University , Olomouc , Czech Republic.
authors.forename: Vít
authors.initials: V
authors.lastname: Procházka
authors.forename: Tomáš
authors.initials: T
authors.lastname: Papajík
authors.forename: Edgar
authors.initials: E
authors.lastname: Faber
authors.forename: Luděk
authors.initials: L
authors.lastname: Raida
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Kapitáňová
authors.forename: Kateřina
authors.initials: K
authors.lastname: Langová
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Prouzová
authors.forename: Marie
authors.initials: M
authors.lastname: Jarošová
authors.forename: Karel
authors.initials: K
authors.lastname: Indrák
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008224:Lymphoma, Follicular / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011241:Prednisone / Q000008:administration & dosage; D011379:Prognosis; D015375:Receptors, Interleukin-2 / Q000097:blood*; D000069283:Rituximab / Q000008:administration & dosage; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D015375:Receptors, Interleukin-2; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone
keywords: CHOP; Follicular; autologous transplant; chemotherapy; interleukin; lymphoma; rituximab