Zinzani P L, Pileri S, Bendandi M, Buzzi M, Sabattini E, Ascani S, Gherlinzoni F, Magagnoli M, Albertini P, Tura S
Institute of Hematology and Oncology Seràgnoli, Roma, Italy.
J Clin Oncol. 1998 Apr;16(4):1532-7. doi: 10.1200/JCO.1998.16.4.1532.
In the last few years, the search for new biologic markers in high-grade non-Hodgkin's lymphomas has provided important results. In particular, soluble CD30 (sCD30) levels were elevated in most patients with Hodgkin's disease (HD) and anaplastic large-cell lymphoma (ALCL).
From September 1988 to October 1993, treatment was completed in 70 previously untreated patients with ALCL, of whom 38 had the common type (ALCL-CT) and 32 had the Hodgkin's-like subtype (ALCL-HL). Serum sCD30 levels were measured at the time of diagnosis and after induction polychemotherapy in all patients; in addition, the initial sCD30 levels were compared with those obtained from 50 stage-matched patients with HD.
Pretreatment levels of sCD30 were highly elevated in the stage-matched group of HD patients compared with healthy controls; median sCD30 levels in patients with ALCL-CT and ALCL-HL were 18 and seven times higher, respectively, than in patients with HD. The sCD30 level normalized on achievement of complete response (CR). The risk of lower relapse-free survival was associated with bulky disease, advanced stage, and high pretreatment sCD30 levels; the risk of lower overall survival was associated with advanced stage and pretreatment levels of sCD30 in both univariate and multivariate analysis.
The results of this study suggest that sCD30 is a specific prognostic indicator of the risk for lower complete response rate and relapse-free expectancy for patients with ALCL.
在过去几年中,对高级别非霍奇金淋巴瘤新生物标志物的研究取得了重要成果。特别是,大多数霍奇金病(HD)和间变性大细胞淋巴瘤(ALCL)患者的可溶性CD30(sCD30)水平升高。
从1988年9月至1993年10月,70例既往未接受治疗的ALCL患者完成了治疗,其中38例为常见类型(ALCL-CT),32例为霍奇金样亚型(ALCL-HL)。所有患者在诊断时和诱导多药化疗后测量血清sCD30水平;此外,将初始sCD30水平与50例分期匹配的HD患者的水平进行比较。
与健康对照组相比,HD患者分期匹配组的预处理sCD30水平显著升高;ALCL-CT和ALCL-HL患者的sCD30中位数水平分别比HD患者高18倍和7倍。完全缓解(CR)时sCD30水平恢复正常。无复发生存率降低的风险与大块病变、晚期和预处理sCD30水平高有关;在单因素和多因素分析中,总生存率降低的风险与晚期和预处理sCD30水平有关。
本研究结果表明,sCD30是ALCL患者完全缓解率降低和无复发生存期风险的特异性预后指标。