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Soluble ICAM-1 in Hodgkin's disease: a promising independent predictive marker for survival
I Christiansen1, G Enblad, K M Kälkner
1Department of Clinical Immunology & Transfusion Medicine, University Hospital, Uppsala, Sweden.
Insights
Serum levels of soluble ICAM-1 (sICAM-1) are elevated in Hodgkin
Area of Science:
- Oncology
- Immunology
- Biomarkers
Background:
- Hodgkin's disease (HD) is a lymphoid malignancy with established prognostic factors.
- Soluble adhesion molecules and cytokine receptors are increasingly recognized as potential biomarkers in various cancers.
- The prognostic significance of serum levels of soluble ICAM-1 (sICAM-1) in HD requires further elucidation.
Purpose of the Study:
- To investigate the association between serum sICAM-1 levels and clinical parameters in Hodgkin's disease.
- To compare the prognostic value of sICAM-1 with other established serum markers in HD.
- To evaluate the potential of sICAM-1 as a predictor of relapse and survival in HD patients.
Main Methods:
- Serum sICAM-1 levels were measured in 101 HD patients and 31 healthy controls.
- Correlations between sICAM-1 and clinical features (B-symptoms, histology, tumor burden, bulky disease) were assessed.
- sICAM-1 was compared with ESR, LDH, TK, sIL-2R, and sCD30 for prognostic value using univariate and multivariate analyses.
Main Results:
- Serum sICAM-1 levels were significantly elevated in HD patients compared to controls (p = .0006).
- sICAM-1 correlated with B-symptoms, histology, and tumor stage, but not bulky disease.
- sICAM-1 showed positive correlations with ESR, LDH, TK, sIL-2R, and sCD30; it correlated with disease-free survival and overall survival in univariate analyses, and independently with survival when dichotomized.
Conclusions:
- Elevated serum sICAM-1 is a feature of Hodgkin's disease and correlates with disease burden.
- sICAM-1, along with sIL-2R and sCD30, demonstrates prognostic value for relapse and survival in HD.
- Serum sICAM-1 determination may aid in selecting HD patients for intensive therapy in clinical trials.
Abstract:
The serum levels of soluble ICAM-1 (sICAM-1, sCD54) were significantly elevated (p = .0006) in patients with Hodgkin's disease (HD) (n = 101) compared to healthy controls (n = 31). Serum levels of sICAM-1 in HD correlated significantly with the presence of B-symptoms, histology and tumour burden as reflected in the Ann Arbor staging system, but not to bulky disease. sICAM-1 was compared to other serum factors claimed to be of prognostic significance in HD, including erythrocyte sedimentation rate (ESR), lactate dehydrogenase (LDH), deoxythymidine kinase (TK), soluble interleukin-2 receptor (sIL-2R, sCD25) and soluble CD30 (sCD30, sKi-1-antigen). Serum levels of sICAM-1 correlated positively with all of these markers. In univariate regression analyses, all but ESR correlated with disease-free survival but only sICAM-1, sIL-2R and sCD30 correlated with overall survival. In multivariate analyses only sIL-2R (as a continuous variable) added independent prognostic information in addition to age, stage and B-symptoms. sICAM-1 and sCD30 approached significance (p = 0.07 and p = 0.08, respectively) for disease-free survival. sCD30 correlated with overall survival (p = 0.03) while sICAM-1 did not. When dichotomised at optimal cut-off levels, sICAM-1 as well as sIL-2R and sCD30 added independent prognostic information for both disease-free and overall survival. Based on the present observations, it appears that sICAM-1 may be a predictor for relapse and survival in HD. Determination of serum levels of sICAM-1 (in addition to sIL-2R and sCD30) may thus be of potential value when selecting HD patients eligible for intensive therapy in clinical trials.