[Estimation and clinical significance of serum soluble tumor necrosis factor receptors in patients with acute leukemia].

OBJECTIVE

To explore the levels of serum soluble tumor necrosis factor receptors (sTNFRs) and the relationships with clinical situation, chemotherapeutic effects and TNF alpha level in acute leukemia (AL) patients.

METHODS

Serum levels of sTNFRs and TNF alpha were measured by ELISA. Six parameters which might influence therapeutic effects were analyzed by logistic regression.

RESULTS

1. Serum levels of sTNFR I and sTNFR II in 31 untreated AL patients were significantly higher than those in controls(P < 0.001 and < 0.005, respectively) and in bone marrow remission (BMR) AL patients (P < 0.005 and < 0.05, respectively). The levels of sTNFR I and sTNFR II in 11 relapsed/refractory AL patients were significantly higher than those in controls(P < 0.001 and < 0.05, respectively), but were not different from those in untreated AL patients. 2. Serum levels of sTNFR I in untreated ALL patients were significantly higher than those in ANLL patients (P < 0.05). 3. High levels of serum sTNFR I were more common in patients with high leukocyte count(> or = 100 x 10(9)/L) and high levels of serum sTNFR II were more common in patients with splenomegaly. Levels of the two sTNFRs positively correlated with blasts in peripheral blood (P < 0.001 and < 0.05, respectively). 4. The level of TNF alpha in 31 untreated AL patients significantly correlated with the level of sTNFR I (r = 0.440, P < 0.05). 5. The BMR rate was higher in those serum sTNFR I level < 2.0 micrograms/L than in those > or = 2.0 micrograms/L(P < 0.05). 6. Of the six parameters which might influence AL therapeutic effects, only sTNFR I < 2.0 micrograms/L was predictive.

CONCLUSION

High levels of serum sTNFRs in AL patients might be derived from leukemic cells and predicted an adverse prognosis.