PLASMA-LEVELS OF TUMOR-NECROSIS-FACTOR AND ITS SOLUBLE RECEPTORS CORRELATE WITH CLINICAL-FEATURES AND OUTCOME OF HODGKINS-DISEASE PATIENTS

A prospective study was performed to assess the use of plasma measurem ent of tumour necrosis factor (TNF), lymphotoxin alpha (LT alpha) and their soluble receptors (p55 and p75) for prognostic risk assignment i n 61 patients with Hodgkin's disease. Plasma levels of TNF, p55 and p7 5, but not of LT alpha, were higher in Hodgkin's disease patients than in healthy controls. Plasma levels of TNF, p55 and p75 were associate d with several prognostic factors for Hodgkin's disease, including tho se related to the host (age, performance status) and to the tumour (di sease stage, extranodal site involvement, bulky tumour, serum levels o f LDH and beta 2-microglobulin, histology). Elevated plasma levels of TNF, p55 and p75 were also associated with several parameters reflecti ng an immune activation, including the presence of B symptoms, elevate d serum levels of gammaglobulins, alkaline phosphatase and fibrinogen, as well as peripheral monocytosis, anaemia and low serum albumin leve ls. Finally, elevated TNF ligand receptor plasma markers were associat ed with a lower incidence of complete response to therapy and predicte d shorter free-from-progression survival and overall survival of the p atients. These results indicate that the plasma levels of TNF and its soluble receptors correlate with clinical features and outcome of pati ents with Hodgkin's disease.