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Blood, Vol. 94 No. 10 (November 15), 1999:
pp. 3541-3550
Prognostic Implications of the Differentiation Inhibitory Factor
nm23-H1 Protein in the Plasma of Aggressive Non-Hodgkin's
Lymphoma
Nozomi Niitsu,
Junko Okabe-Kado,
Takashi Kasukabe,
Yuri Yamamoto-Yamaguchi,
Masanori Umeda, and
Yoshio Honma
From Saitama Cancer Center Research Institute, Saitama, Japan; and
the First Department of Internal Medicine, Toho University School of
Medicine, Tokyo, Japan.
The outcome of patients with non-Hodgkin's lymphoma has been
improved by current approaches to treatment. Nevertheless, many patients either do not have a complete remission or ultimately relapse.
To identify such patients, it is important to be able to predict the
outcome. We previously found that the differentiation inhibitory
factor/nm23 was correlated with the prognosis of acute myeloid
leukemia. To examine the prognostic effect of nm23 on non-Hodgkin's lymphoma, we established an enzyme-linked immunosorbent assay procedure to determine nm23-H1 protein levels in plasma and assessed the association of this protein level with the response to
chemotherapy, overall survival, and progression-free survival in
patients with aggressive non-Hodgkin's lymphoma. The plasma concentration of nm23-H1 was significantly higher in patients with malignant lymphoma than in normal controls, especially in aggressive non-Hodgkin's lymphoma. The complete remission rate in
patients with higher nm23-H1 levels was significantly worse than that in patients with lower nm23-H1 levels. Overall
survival and progression-free survival were also lower in patients with higher nm23-H1 levels than in those with lower levels. The
3-year survival rates in patients with low and high nm23-H1
levels were 79.5% and 6.7% (P = .0001). A multivariate
analysis of prognostic factors showed that the plasma nm23-H1
level was independently associated with the survival and
progression-free survival. An elevated plasma nm23-H1
concentration predicts a poor outcome of advanced non-Hodgkin's
lymphoma. Therefore, nm23-H1 in plasma may be useful for
identifying a distinct group of patients at very high risk.
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