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Serum Level of the Soluble Form of the CD30 Molecule Identifies
Patients With Hodgkin's Disease at High Risk of Unfavorable Outcome
Gianpaolo Nadali,
Luisa Tavecchia,
Elisabetta Zanolin,
Valeria Bonfante,
Simonetta Viviani,
Edgarda Camerini,
Pellegrino Musto,
Nicola Di Renzo,
Mario Carotenuto,
Marco Chilosi,
Mauro Krampera, and
Giovanni Pizzolo
From the Departments of Hematology, Medical Statistics, and
Pathology, Verona University School of Medicine, Verona; Department of
Medical Oncology, Istituto Nazionale per lo Studio e la Cura dei
Tumori, Milano; and the Department of Hematology, IRCCS "Casa
Sollievo della Sofferenza," S. Giovanni Rotondo, Italy.
Preliminary reports suggested a prognostic significance for serum
levels of soluble CD30 (sCD30) in patients with Hodgkin's disease
(HD). In this study, we investigated the prognostic impact of sCD30
concentration at diagnosis in relation to the other recognized prognostic parameters in 303 patients with HD observed in three different institutions between 1984 and 1996. sCD30 levels were correlated with stage, presence of B symptoms, and tumor burden. High
sCD30 levels entailed a higher risk of poor outcome, and the event-free
survival (EFS) probability at 5 years for patients with sCD30 levels
 100 and less than 100 U/mL was 59.9% (95% confidence interval
[CI], 40.6% to 65.9%) and 87.5% (95% CI, 81.5% to 91.6%), respectively (P < .001). On the basis of the results of
univariate analysis of 14 pretreatment characteristics, we included
five prognostic factors (high sCD30 serum level, stage III-IV, B
symptoms, low hemoglobin level, and age 50 years) into a
multivariate model. High sCD30 and advanced stage were independently
associated with an unfavorable prognosis. Their combined evaluation
identified patients at high risk (stages III and IV and sCD30 100
U/mL: EFS, 46.9%) and low risk (stages I and II with sCD30 <100
U/mL: EFS, 88.7%) of treatment failure (P < .001). We
conclude that the combined evaluation of sCD30 serum level and stage at
presentation identifies patients with HD at high risk of an unfavorable
outcome.
Blood, Vol. 91 No. 8 (April 15), 1998:
pp. 3011-3016
© 1998 by The American Society of Hematology.
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