EXPRESSION OF THE ADHESION MOLECULE ICAM-1 IN NON-HODGKINS-LYMPHOMA -RELATIONSHIP WITH TUMOR DISSEMINATION AND PROGNOSTIC IMPORTANCE

Purpose: To study the expression of intercellular adhesion molecule-1 (ICAM-1) by non-Hodgkin's lymphomas and to assess its correlation with disease extension and prognosis. Patients and Methods: ICAM-1 (CD54-I OL54) expression was studied in 70 patients (35 male/35 female; median age, 56 years) with non-Hodgkin's lymphoma from a single institution. Immunostaining was performed using a streptavidine-biotin alkaline ph osphatase method and ICAM-1 expression was evaluated in a semiquantita tive manner. The histologic distribution of the cases was the followin g: small lymphocytic, five cases; follicular, 14; mantle cell, five; d iffuse large cell, 41; and T lymphoblastic, five. Forty patients (57%) were in stage IV, bulky disease was observed in 25 patients (36%), an d extranodal involvement in 48 patients (69%). Results: ICAM-1 express ion was negative (-) in 14 patients (20%), weak (+) in 21 (30%), posit ive (++) in 30 (43%), and strongly positive (+++) in five (7%). No sig nificant relationship was found between ICAM-1 expression and the lymp homa histologic subtype. Patients with negative or weak ICAM-1 express ion had more frequently disseminated (stage IV) disease (74% v 40%; P = .007), extranodal involvement (86% v 51%; P = .004), and bone marrow infiltration (57% v 26%; P = .015) than the remainders. Positive ICAM -1 patients had survival rates significantly better than those in whom ICAM-1 was negative or weakly expressed [2-year overall survival: 77% v 50%, respectively; P < .025]. In a multivariate study, ICAM-1 (P = .005) maintained, along with histologic subtype (P = .001) and the int ernational prognostic index (IPI) (P = .056), its importance for predi cting survival. Finally, when the group of aggressive non-Hodgkin's ly mphoma patients was analyzed, ICAM-1 expression inversely correlated w ith advanced stage (P = .025), extranodal involvement (P = .01), and b one marrow infiltration (P = .01), complete response (CR) achievement (65% v 32%; P = .025), and overall survival (70% v 26% at 2 years; P < .005). Conclusion: In lymphoma patients, ICAM-1 expression correlates with lymphoma dissemination and is useful to assess prognosis. (C) 19 98 by American Society of Clinical Oncology.