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Annals of Oncology 11:1405-1411, 2000
© 2000 European Society for Medical Oncology

research-article

Biological markers may add to prediction of outcome achieved by the international prognostic score in Hodgkin's disease

U. Axdorph1,, J. Sjöberg1, G. Grimfors1, O. Landgren1, A. Porwit-MacDonald2 and M. Björkholm1

1Division of Hematology, Department of Medicine, Karolinska Hospital and Institutet Stockholm, Sweden
2Department of Pathology and Cytology, Karolinska Hospital and Institutet Stockholm, Sweden

Correspondence to: U. Axdorph, MD Division of Hematology Department of Medicine Karolinska Hospital 171 76 Stockholm, Sweden E-mail: ulla.axdorph{at}ks.se

BACKGROUND: The International Prognostic Score (IPS) identifies seven independent factors predicting progression-free and overall survival in advanced stage Hodgkin's disease (HD). The IPS is also applicable in limited disease. However, the IPS does not identify patients with a very poor prognosis. The aim of this study was to define biological markers which may add to the IPS in predicting outcome.

PATIENTS AND METHODS: One hundred forty-five patients (>15 years) with HD of all stages and histopathology sub groups were included. In addition to factors included in the IPS, serum levels of CRP, sCD4, sCD8, sCD25, sCD30, sCD54, interleukin (IL)-10, ß2-microglobulin and thymidine kinase were analysed.

RESULTS: The strongest predictors of a poor cause-specific survival (CSS) in univariate analyses were: increased serum levels of IL-10, sCD30 and CRP, anaemia, low levels of albumin (P < 0.001); stage IV (P = 0.003), age ≥ 45 years (P = 0.006), increased serum levels of sCD25 (P = 0.010), low lymphocyte counts (P = 0.020). Serum IL-10 added prognostic information to that achieved by the IPS: patients with a high score and increased serum IL-10 had a very poor outcome with a five-year CSS of 38%. Patients with increased serum levels of sCD30 and a high score also had a poor outcome with a five-year CSS of 54%.

CONCLUSION: Serum levels of IL-10 and sCD30 may add to IPS in prediction of outcome in HD, and should be validated in large, prospective studies.

Hodgkin's disease, interleukin-10, prognosis, prognostic score, sCD30


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