Annals of Oncology 14:467-474, 2003
© 2003 European Society for Medical Oncology
Original Paper |
Soluble intercellular adhesion molecule-1 (s-ICAM-1/s-CD54) in diffuse large B-cell lymphoma: association with clinical characteristics and outcome
Departments of 1 Hematology and Medical Oncology and 2 Pathology, Hospital Clínico Universitario, University of Valencia, Valencia 3 Hematology Section, Hospital Francesc de Borja, Gandia, Spain
Received 8 April 2002; revised 26 July 2002; accepted 9 September 2002
Background:
High serum levels of soluble intercellular adhesion molecule-1(s-ICAM-1/s-CD54) have been associated with adverse clinical features and poor outcome in chronic lymphocytic leukemia, Hodgkin’s disease and non-Hodgkin’s lymphoma, but their value in the different subtypes of non-Hodgkin’s lymphoma has not been well addressed.
Patients and methods:
Our aim was to study the serum levels of s-ICAM-1 in diffuse large B-cell lymphoma (DLBCL) and to correlate them with clinical characteristics and outcome. We analyzed the serum levels of s-ICAM-1 in a series of 55 patients with DLBCL diagnosed in a single institution. s-ICAM-1 levels were quantified by an immunoenzymatic assay. Median age was 62 years (range 22–96); 29 (53%) were male. Twenty-eight (51%) presented with advanced clinical stage (III/IV), 32 (58%) had extranodal involvement, 28 (51%) had high serum lactate dehydrogenase (LDH) and 23 (43%) had high ß2-microglobulin levels. All patients received anthracycline-containing regimens. Correlation between clinical variables and s-ICAM-1 levels were tested with the Mann–Whitney U-test and survival was plotted by the Kaplan–Meier method, and curves compared with the log-rank test.
Results:
Serum levels of s-ICAM-1 were significantly increased in patients with DLBCL compared with normal controls (589 ± 487 versus 279 ± 65 ng/ml, respectively; P <0.001). Higher levels of s-ICAM-1 were present in patients with B symptoms, advanced stage and increased LDH and ß2-microglobulin. s-ICAM-1 levels also correlated with achievement of a complete response. Patients with s-ICAM-1 over 668 ng/ml had a shorter time to treatment failure (TTF) (3-year TTF, 59% versus 20%, respectively; P = 0.01) and overall survival (OS) (3-year OS, 58% versus 22%, respectively; P = 0.04) than the remainders. When only low and low–intermediate risk patients in the international prognostic index score were considered, those with s-ICAM-1 over 668 ng/ml also had worse TTF and OS.
Conclusions:
In DLBCL, s-ICAM-1 levels correlated with high tumor burden and lymphoma dissemination and may contribute to assessment of prognosis.
Key words: diffuse large B-cell lymphoma, prognosis, soluble intercellular adhesion molecule-1 (CD54)
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