The significance of serum levels of soluble 60kDa receptors for tumor necrosis factor in patients with Hodgkin's disease.

Soluble forms of the two molecular species of the cell surface receptors (Rs) for tumor necrosis factor (TNF) have been detected in normal urine and serum including type I and type II TNF-Rs. Using enzyme-linked immunosorbent assay we have determined type I 60 kDa sTNF-R levels in the sera of 45 age- and sex-matched healthy subjects and 106 patients with Hodgkin's disease (HD). HD patients were either previously untreated (n = 76) or were in complete remission for at least 3 years after remission induction treatment (n = 30). The mean +/- SD concentrations of the 60 kDa type sTNF-R were significantly higher in HD patients than in healthy controls (1.32 +/- 0.19 ng/ml versus 0.6 +/- 0.13 ng/ml; p < 0.001). The extent of increase correlated with the disease stage. Soluble 60 KDa TNF-Rs were found to be significantly higher in stage III and IV (1.42 +/- 0.21 ng/ml) than in stages I and II (1.08 +/- 0.15 ng/ml). Patients with B-symptoms (n = 33) had higher levels (1.67 +/- 0.20 ng/ml) than patients without systemic symptoms (1.02 +/- 0.11 ng/ml; p < 0.001). In 52 patients evaluable for response, the complete remission (CR) rate of patients with 60 kDa sTNF-Rs < 1.2 ng/ml was higher (88%) than in those with 60 kDa sTNF-Rs > 1.2 ng/ml (64%; p < 0.01). A significant increase in serum levels of 60 kDa sTNF-R levels was also observed in HD patients in long-standing CR (1.04 +/- 0.10 ng/ml). Our data suggest that the pretreatment serum concentration of 60 kDa sTNF-Rs in HD may bear prognostic relevance. Increased 60 kDa sTNF-R levels seen in HD patients in remission may point to the defect in cellular immunity characteristic of HD patients.