Comparison of serum sIL-2R and LDH levels in patients with intravascular large B-cell lymphoma and patients with advanced stage diffuse large B-cell lymphoma

Abstract

Intravascular large B-cell lymphoma (IVL) is a rare type of lymphoma characterized by tumor growth selectively within the vessels. The 5 th edition of the World Health Organization classification defines IVL as a large B-cell lymphoma, the same as diffuse large B-cell lymphoma, not otherwise specified (DLBCL, NOS). Since the clinical manifestations of IVL are nonspecific, the diagnosis is time-consuming, and the course is often fatal. Serum soluble interleukin-2 receptor (sIL-2R) and serum lactate dehydrogenase (LDH) levels are known to be elevated in a variety of lymphomas. However, the mechanism of sIL-2R elevation in B-cell lymphomas is not fully understood. In this study, we analyzed the serum level of laboratory findings, including sIL-2R and LDH, as well as the presence of B symptoms in 39 patients with IVL, and compared them with 56 patients with stage IV DLBCL. Both sIL-2R and LDH levels were significantly higher in IVL than in DLBCL (p = 0.035 and p = 0.002, respectively). In IVL, there were no significant differences in both sIL-2R and LDH levels between patients with and without B symptoms (p = 0.206 and p = 0.441, respectively). However, in DLBCL, both sIL-2R and LDH levels were significantly higher in the presence of B symptoms (p = 0.001 and p < 0.001, respectively). The high sIL-2R and LDH levels in IVL may be related to the peripheral blood microenvironment, but further studies are needed to verify this.

Asian Variant Intravascular Lymphoma: A Look at the Laboratory Data of Lactase Dehydrogenase and Soluble Interleukin-2 Receptor

“…Blood LD levels are elevated in AIVL [ 3 ]. Tumor lysis is more likely to disintegrate when tumor cells are intravascular than when they are present as a mass, implying more elevated LD levels than general types of lymphomas [ 3 ].…”

“…Blood LD levels are elevated in AIVL [ 3 ]. Tumor lysis is more likely to disintegrate when tumor cells are intravascular than when they are present as a mass, implying more elevated LD levels than general types of lymphomas [ 3 ]. Such patients can also have DIC, as in our case, resulting in elevated LD due to cell damage and necrosis [ 3 ].…”

“…Tumor lysis is more likely to disintegrate when tumor cells are intravascular than when they are present as a mass, implying more elevated LD levels than general types of lymphomas [ 3 ]. Such patients can also have DIC, as in our case, resulting in elevated LD due to cell damage and necrosis [ 3 ]. Blood sIL-2R levels are elevated when matrix metalloproteinase-9 and tumor-associated macrophages induce the generation of sIL-2R and the cleavage of IL-2Rα-chains on the plasma membrane [ 13 , 14 ].…”

“…Because AIVL is more prevalently complicated by a syndrome of inappropriate antidiuretic hormone selection (SIADH) (66.7% of AIVL patients) than lymphoma (6.8%), it can have a late diagnosis, while the causes of SIADH are explored [2]. Although lactase dehydrogenase (LD) and soluble interleukin-2 receptor (sIL-2R) in the blood are generally thought to be useful markers for diagnosing lymphomas, these markers might be overlooked for AIVL; indeed, prior reports on AIVL complicated by SIADH have diagnosed AIVL post-mortem without the full utility of LD or sIL-2R [3][4][5][6]. Thus, it is necessary to emphasize cases that are diagnosed through the detection of LD and sIL-2R.…”