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Blood, 1 March 2001, Vol. 97, No. 5, pp. 1202-1210
CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS
Serum nm23-H1 protein as a prognostic factor in aggressive
non-Hodgkin lymphoma
Nozomi Niitsu,
Junko Okabe-Kado,
Masataka Okamoto,
Toshiyuki Takagi,
Takashi Yoshida,
Sadao Aoki,
Masami Hirano, and
Yoshio Honma
From the First Department of Internal Medicine, Toho
University School of Medicine, Tokyo; Research Institute, Saitama
Cancer Center, Saitama; the Department of Internal Medicine, Fujita
Health University School of Medicine, Toyoake; Hematology-Oncology
Division, Chiba Cancer Center Hospital, Chiba; Toyama Prefectural
Central Hospital, Toyama; and the First Department of Internal
Medicine, Niigata University School of Medicine, Niigata, Japan.
Advances in chemotherapy have led to a favorable long-term
prognosis in approximately 50% of patients with aggressive non-Hodgkin lymphoma (NHL). However, the remaining patients do not enjoy such prolonged survival after standard treatment. New prognostic factors are
needed to define this poor-prognosis group and to plan an appropriate
treatment strategy. It has been reported that serum nm23-H1 protein may
be a new prognostic factor for aggressive NHL. In the present study
involving multiple institutions and a large number of patients, the
level of nm23-H1 protein was compared among different types of
lymphoma; it was lowest for indolent lymphoma, followed by aggressive
lymphoma and then highly aggressive lymphoma. In addition, patients
with aggressive NHL and higher nm23-H1 levels had worse overall and
progression-free survival rates than those with lower nm23-H1 levels.
The nm23-H1 level was also compared between patients with diffuse large
B-cell lymphoma and patients with peripheral T-cell lymphoma. The
results suggest that the level of nm23-H1 could serve as a prognostic
factor in both groups. Moreover, the prognosis of lymphoma patients
could be ascertained even more precisely by combining soluble
interleukin-2 receptor or soluble CD44 and nm23-H1 levels. A
multivariate analysis confirmed that the nm23-H1 level is an
independent and important prognostic factor in aggressive NHL.
Therefore, it may provide useful information for clinicians to
determine the appropriate therapy for each type of lymphoma.
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