[Serum ferritin--a tumor marker in malignant lymphomas?]

Serum ferritin concentration as a tumor associated marker was investigated in 535 patients with malignant lymphomas. The study included 207 patients with Hodgkin lymphomas, 196 patients with low grade malignant Non Hodgkin lymphomas and 132 patients with high grade malignant Non Hodgkin lymphomas of different tumor stages. Increased serum ferritin concentrations were found in 54% of the unselected patients. In particular, serum ferritin concentration was elevated in 12.3% of patients with stage I, in 33.8% of patients with stage II, in 72.2% of patients with stage III and in 94% of patients with stage IV. The serum ferritin levels correlated with the tumor mass. There was no difference between Hodgkin lymphomas and Non Hodgkin lymphomas. In patients with concomittant hepatocellular disease or during chemotherapy inadequate high serum ferritin concentrations were found, which did not correlate with tumor mass. In patients with primary bone marrow infiltration by some low grade malignant Non Hodgkin lymphomas serum ferritin levels correlated better with the tumor stages according to Rai than with the Ann-Arbor-classification. The serum ferritin concentration followed closely the activity of the disease: Increased pretreatment serum ferritin levels normalized completely, when patients achieved complete remission. In contrast, in patients with tumor relapse or tumor progression serum ferritin levels increased again. The data suggest that the serum ferritin concentration can be used for follow-up of patients with malignant lymphomas. Because of its limited specifity and low sensitivity it cannot be used as a screening test. Nevertheless, it is a helpful additional parameter for the control of the activity of the disease.