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M9470145.TXT
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1994-07-02
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Document 0145
DOCN M9470145
TI Significance of soluble interleukin-2 receptor levels for evaluation of
the progression of adult T-cell leukemia.
DT 9409
AU Kamihira S; Atogami S; Sohda H; Momita S; Yamada Y; Tomonaga M; Blood
Transfusion Service, Nagasaki University Hospital, Japan.
SO Cancer. 1994 Jun 1;73(11):2753-8. Unique Identifier : AIDSLINE
MED/94251714
AB BACKGROUND. The authors conducted a survey of a large cohort of patients
with adult T-cell leukemia (ATL) and a group of human T-cell leukemia
virus type 1 (HTLV-1) carriers to elucidate whether measurements of
soluble interleukin-2 receptor (sIL-2R) levels are indicative of ATL
tumor burden and correlate with clinical progression. METHODS. Using a
sandwich enzyme immunoassay, the authors determined sIL-2R in the serum
of 135 patients with ATL diagnosed and subclassified according to the
Japan Lymphoma Study Group criteria and in the serum of healthy HTLV-1
seropositive persons. Also included were patients in the preleukemic
state of ATL (pre-ATL), which is characterized by only slight blood
changes but does not fit the diagnostic criteria of ATL. In the five
subjects who finally advanced to overt ATL, the authors prospectively
performed serial measurements of the receptor. RESULTS. Serial
measurements of sIL-2R levels taken until overt ATL developed showed
that these levels in the initial samples were higher than those of
control subjects, even when subjects were asymptomatic or in the pre-ATL
state. The serial levels of the five subjects gradually increased
despite being in a clinically stable condition, finally reaching
markedly high levels at the time ATL became overt. The mean sIL-2R
levels of the smoldering, chronic, acute, and lymphoma subtypes of ATL
were 1680 U/ml, 6680 U/ml, 45,940 U/ml, and 34,620 U/ml, respectively (P
< 0.01). The sIL-2R levels of each subtype at the time of diagnosis were
more correlated with tumor burden, malignant behavior, and prognosis
than lactate dehydrogenase (LDH) levels. In the low, moderate, and high
sIL-2R subgroups, the median survival time and percent survival
probability at 2 years was 30.2 months (46.0%), 16.5 months (25.0%), and
7.7 months (15.3%), respectively. CONCLUSIONS. Serial measurements of
sIL-2R levels are of clinical importance because changes of the levels
correlate with disease progression, especially in early phase of ATL.
The data suggest that sIL-2R may be more useful than LDH. In addition,
emphasis may be placed on sIL-2R as an indicator of ATL progression
status and prognosis for survival. The value of this marker in clinical
practice should be confirmed prospectively.
DE Carrier State/PATHOLOGY Human HTLV-I Infections/PATHOLOGY
Immunoenzyme Techniques Leukemia-Lymphoma, T-Cell, Acute,
HTLV-I-Associated/MORTALITY/ *PATHOLOGY Middle Age
Preleukemia/PATHOLOGY Receptors, Interleukin-2/*ANALYSIS Solubility
Support, Non-U.S. Gov't Survival Rate JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).