Soluble cytokine levels correlate with the activity and clinical stage of Hodgkin's disease at diagnosis.

The serum levels of some cytokines seem to correlate with outcome in Hodgkin's disease (HD) and may be helpful in formulating new and better prognostic systems. The aim of this study was to analyse the correlations between the serum levels of different cytokines and the clinico-hematological features suggestive of a worse prognosis. The study involved 31 pts with a "de novo" diagnosis of HD (median age: 30 yrs; M/F: 13/18; stage I/II vs III/IV: 19/12; B symptoms: 12; bulky disease and extranodal disease: 9). The serum levels of sCD30, TNFalpha, TNF receptor I and II, IL6, IL6 receptor, IL10, sICAM-1 were evaluated at diagnosis, and correlated with gender, age (< or =/> 30), stage (I-II vs III-IV), systemic symptoms, bulky disease, ESR (</> or = 40), serum copper (< or =/> 170 microg/dL), WBC counts (< or =/> 15x10(9)/L), prognostic scores (PS) according to Hasenclever (</> or = 2), and the presence of extranodal disease. Stages III/IV were associated with significantly higher levels of sCD30 and TNF-RI (p=0.03), systemic symptoms with significantly higher levels of sCD30, TNFalpha, IL6, TNF-RI (p=0.027, 0.03, 0.0005, 0.002), bulky disease with TNF-RI (p=0.03), high ESR with IL6 and TNF-RI (p=0.0011, 0.0001), high WBC counts with sCD30, IL6, TNF-RI (p=0.03, 0.002, 0.01), high serum copper with sCD30 and IL6 (p=0.05, 0.0004), higher PS with sCD30, IL6, TNF-RI (p=0.002, 0.0003, 0.005), extranodal disease with TNFalpha and IL6 (p=0.05, 0.01). It was possible to define cut-off levels for some cytokines (sCD30 > 33.15 U/mL, TNFalpha > 29.71 pg/mL, IL6 > 12.43 pg/mL, TNF-RI > 3.23 ng/mL, IL6-R > 57 ng/mL) that significantly correlate with systemic symptoms, higher disease stages, ESR, serum copper, WBC counts and PS. Our study shows that high sCD30, TNFalpha, IL6 and TNF-RI levels are associated with advanced disease or a worse prognostic score. In the context of multiparametric HD staging, cytokine evaluation may be useful for identifying candidates for more intensive therapies.