Journal d'hématologie et des maladies thromboemboliques
Libre accès
ISSN: 2329-8790
ISSN: 2329-8790
Ratiorn Pornkuna1, Shigeki Takemoto1,2*, Michihiro Hidaka2, Fumio Kawano2 and Yoshio Haga1,3
Adult T-cell leukemia/lymphoma (ATLL) is an incurable neoplasm of mature T-cells with a median survival time of approximately one year. The aim of this study was to compare the clinical value of soluble CD30 (sCD30) levels with soluble IL-2 receptor α chain (sIL-2R) levels in two different clinical settings of ATLL patients; before an initial therapy of chemotherapy or gastric resection (n=32), and before allogeneic hematopoietic stem cell transplantation (HSCT; n=24). All patients completed the 2-year follow-up. Both sIL-2R (p=0.016) and sCD30 (p=0.030) levels were significant predictors of overall survival before the initial therapy. The number of ATLL cells in peripheral blood (PB) was correlated with sCD30 levels (Spearman’s correlation coefficient, ρ=0.46; p=0.009) but not with sIL-2R levels (ρ=0.16; P=0.38). Patients who survived for longer than two years, and for whom the percentage of ATLL cells in PB were <5%, displayed relatively low sCD30 levels, but this tendency for low sCD30 levels was not observed in longterm survivors whose ATLL cells constituted ≥5% of PB cells. sIL-2R (p=0.041) and sCD30 (p=0.0003) values were both significant predictors of overall survival in HSCT, but sCD30 levels predicted more patients with early death than were predicted by sIL-2R levels. Combination of sCD30 and CRP levels showed high sensitivity and specificity for detection of early death (within 100 days) following HSCT (81.8% and 84.6%, respectively). These results suggest that analysis of sCD30 levels may be useful for prediction of overall survival in ATLL patients, especially before HSCT. These findings would alter the treatment strategy and improve the prognosis of ATLL.