Korean J Lab Med.  2010 Dec;30(6):600-605. 10.3343/kjlm.2010.30.6.600.

Clinical Relevance of Elevated Levels of Serum Soluble Interleukin-2 Receptor alpha (sIL-2Ralpha) in Patients with Non-Hodgkin's Lymphoma

• Jo SA
• Hwang SH
• Chang CL
• Kim SY
• Shin HJ
• Chung JS
• Sol MY
• Lee EY

• KMID: 1781666
• DOI: http://doi.org/10.3343/kjlm.2010.30.6.600

Abstract

Levels of soluble interleukin-2 receptor alpha (sIL-2Ralpha) are known to increase in the sera of patients with certain malignancies, including malignant lymphoma. This study aimed to assess the clinical significance of the sIL-2Ralpha level in non-Hodgkin's lymphoma (NHL). We used ELISA to measure the sIL-2Ralpha levels in 48 newly diagnosed and untreated patients with NHL and evaluated the correlation between the sIL-2Ralpha levels and clinical characteristics and the International Prognostic Index (IPI). We monitored serum sIL-2Ralpha in 7 patients to compare the changes in their clinical progress with these levels. High levels of serum sIL-2Ralpha (> or =2,000 U/mL) correlated well with parameters defining the high risk group according to the IPI, i.e., high tumor burden at diagnosis (stage III+IV) and lactate dehydrogenase > or =472 U/L. The levels were also associated with B symptoms, bone marrow involvement, and poor response to therapy. The sIL-2Ralpha level decreased during complete remission and was elevated during disease progression or relapse. A high level of sIL-2Ralpha was significantly associated with a low survival rate. These results suggest that serum sIL-2Ralpha might be useful as a biomarker for evaluating the prognosis of patients with NHL at the time of diagnosis and during therapy. A well-controlled, large-scale study is needed to clarify the clinical significance of sIL-2Ralpha in specific groups of NHL.

Keyword

Soluble interleukin-2 receptor (sIL-2R); International Prognostic Index; Non-Hodgkin's lymphoma

MeSH Terms

Aged
Biological Markers/blood
Female
Humans
Interleukin-2 Receptor alpha Subunit/*blood
L-Lactate Dehydrogenase/blood
Lymphoma, Non-Hodgkin/*diagnosis/metabolism/mortality
Male
Middle Aged
Neoplasm Staging
Survival Rate

Figure

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  Fig. 1. Serum soluble interleukin-2 receptor alpha (sIL-2Rα) levels according to the International Prognostic Index (IPI) risk group (Kruskall-Wallis test, P=0.005).

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  Fig. 2. Serial analysis of serum soluble interleukin-2 receptor alpha (sIL-2Rα) levels in non-Hodgkin's lymphoma patients showing complete remission (CR), through stable disease (SD) or partial remission (PR); sIL-2Rα levels in relation to the timing of chemotherapy, and with respect to radiographic evaluations. (A) A 36-yr-old man with anaplastic large cell lymphoma in the inguinal lymph nodes treated with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP). (B) A 40-yr-old man with diffuse large B cell lymphoma in the small bowel lymph nodes treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). (C) A 60-yr-old man with B cell malignant lymphoma in the oral cavity treated with rituximab, cyclophosphamide, vincristine, and prednisone (R-CVP).

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  Fig. 3. Serial analysis of serum soluble interleukin-2 receptor alpha (sIL-2Rα) levels in non-Hodgkin's lymphoma patients showing recurrence or progressive disease (PD) after partial remission (PR); sIL-2Rα levels in relation to the timing of chemotherapy, and with respect to radiographic evaluations. (A) A 48-yr-old woman with follicular lymphoma in the axillary lymph nodes treated with rituximab, cyclophosphamide, vincristine, and prednisone (R-CVP). (B) A 64-yr-old man with angioimmunoblastic T cell lymphoma in the neck treated with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP). (C) A 53-year-old man with angioimmunoblastic lymphoma in the cervical lymph nodes treated with CHOP.

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  Fig. 4. Overall survival curves for non-Hodgkin's lymphoma patients in relation to soluble interleukin-2 receptor alpha (sIL-2Rα) level; overall survival curves according to low (<2,000 U/mL) versus high (≥2,000 U/mL) level of sIL-2Rα (Log-rank test, P=0.041).

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