SOLUBLE INTERLEUKIN-2 RECEPTORS (SIL-2R) IN HODGKINS-DISEASE - OUTCOME AND CLINICAL IMPLICATIONS

The aim of this study was to assess the prognostic role of soluble int erleukin-2 receptors (slL-2R) in Hodgkin's disease (HD) both in the ac hievement of complete remission (CR) and in predicting disease relapse . Between August 1938 and June 1993 slL-2R serum levels were measured in 174 untreated patients; in 137 of them evaluation was repeated at t he end of treatment and in 132 also during the followup. Baseline slL- 2R levels (mean +/- standard error) were significantly higher in patie nts than in 65 healthy control subjects (1842 +/- 129 U ml(-1) vs 420 +/- 10 U ml(-1), P < 0.0001). At the end of treatment 135 out of 137 e valuated patients achieved complete response (CR) and their mean slL-2 R serum levels were significantly lower than those at diagnosis (635 /- 19 U ml(-1) vs 1795 +/- 122 U ml(-1), P = 0.0001). After a median f ollow-up of 5 years, slL-2R remained low in 114 patients in continuous CR, while they increased in 9 out of 12 patients (75%) who relapsed. However, a temporary increase was also observed in six patients (5%) s till in CR. Treatment outcome in terms of freedom from progression was linearly related to sIL-2R levels. Our study confirms that patients w ith untreated HD have increased baseline levels of slL-2R compared wit h healthy subjects and that their pretreatment values may be an indica tion of disease outcome similar to other conventional prognostic facto rs, such as number of involved sites, presence of B symptoms and extra nodal extent.