CLINICAL IMPLICATIONS OF SERUM LEVELS OF SOLUBLE CD23 AND TUMOR-NECROSIS-FACTOR-ALPHA IN LOW-GRADE NON-HODGKINS-LYMPHOMA

In the last few years the research for new biological features in low- grade non-Hodgkin's lymphoma has provided important results. Several b iological parameters are under evaluation and, in particular, cytokine s and soluble receptors levels are showing their importance as prognos tic parameters. In the present study, serum levels of tumor necrosis f actor alpha (TNF-alpha) and soluble CD23 (sCD23) were measured at the time of diagnosis and after induction polychemotherapy in 40 patients with newly diagnosed low-grade non-Hodgkin's lymphoma (LG-NHL). The tr eaments were CIOP (cyclophosphamide, idarubicin, vincristine, predniso ne) regimen for 28 patients and FMP (fludarabine, mitoxantrone, predni sone) scheme for 12 patients. Pretreatment levels of TNF-alpha were hi ghly elevated in patients with LG-NHL compared with healthy controls ( p=0.005) and were significantly correlated with the Ann Arbor stage (p =0.001). sCD23 was detected in 35 patients at diagnosis and were marke dly increased in LG-NHL patients when compared to healthy controls (p= 0.005); patients with advanced stage presented higher values than thos e with early stage disease (p=0.002). All the complete responders (20/ 40, 50%) showed a decrease of TNF-alpha and sCD23 levels. By contrast, the combination of high levels of TNF-alpha and sCD23 correspond to a group of non-responders. Our results suggest that TNF-alpha and sCD23 are specific prognostic parameters for LG-NHL, and that they could be used as tumor markers within a potential biological prognostic index.