Increased serum CD8 antigen level in childhood Hodgkin's disease relates to
advanced stage and poor treatment outcome
CH Pui, SH Ip, E Thompson, RK Dodge, M Brown, J Wilimas, S Carrabis, P Kung, CW Berard and WM Crist
Department of Hematology-Oncology, St Jude Children's Research Hospital,
Memphis, TN 38101.
Measurement of the soluble form of CD8 antigen, a surface membrane
component of suppressor/cytotoxic T cells, has yielded useful information
relevant to prognosis in the lymphoid malignancies of childhood. We
therefore determined pretreatment levels of serum CD8 antigen in 90
children with newly diagnosed Hodgkin's disease. The findings ranged
widely, from 220 to 2,585 U/mL (median, 556 U/mL). In patients with
advanced disease (stage III or IV), the median serum CD8 level was
significantly higher than in those with less disease extension (stage I or
II): 675 v 477 U/mL, P = .003. It was also higher in children with B
symptoms compared with all others: 622 v 494 U/mL, P = .005. Cases with a
histologic classification of mixed cellularity had a significantly higher
median level of the antigen than did those classified as nodular sclerosis:
847 v 509 U/mL, P = .005. Finally, higher serum CD8 levels (greater than
430 U/mL) were significantly associated with an increased probability of
treatment failure (P = .02). In a multivariate analysis, serum CD8 level
retained its impact on treatment outcome after adjustment for other
potentially useful prognostic factors, including disease stage, presence of
B symptoms, histology, erythrocyte sedimentation rate, sex, age, and race.
The prognostic strength shown by soluble CD8 in this analysis suggests that
the antigen has clinical value. We postulate that increased CD8 levels in
serum indicate enhanced suppressor T-cell activity, which may compromise
the host's antitumor immunity, leading to unusually aggressive disease.
Volume 73,
Issue 1,
pp. 209-213,
01/01/1989
Copyright © 1989 by The American Society of Hematology
