Plasma thymus and activation-regulated chemokine as an early response marker in classical Hodgkin's lymphoma

Abstract

The online version of this article has a Supplementary Appendix. BackgroundPlasma thymus and activation-regulated chemokine is a potential biomarker for classical Hodgkin's lymphoma. To define its value as a marker to monitor treatment response, we correlated serial plasma thymus and activation-regulated chemokine levels with clinical response in newly diagnosed and relapsed classical Hodgkin's lymphoma patients. Design and MethodsPlasma was collected from 60 (39 early stage and 21 advanced stage) newly diagnosed classical Hodgkin's lymphoma patients before, during, and after treatment, and from 12 relapsed patients before and after treatment. Plasma thymus and activation-regulated chemokine levels were determined by enzyme-linked immunosorbent assay and were related to pre-treatment metabolic tumor volume, as measured by quantification of 2-[18F]fluoro-2-deoxyglucose positron emission tomography images, and to treatment response. ResultsBaseline plasma thymus and activation-regulated chemokine levels correlated with stage of disease and bulky disease, and more closely with metabolic tumor volume. Response to treatment was observed among 38 of 39 early stage and 19 of 21 advanced stage patients. Reduction in plasma thymus and activation-regulated chemokine to normal range levels could be observed as early as after one cycle of chemotherapy in all responsive patients, while plasma levels remained elevated during and after treatment in the 3 non-responsive patients. Plasma thymus and activation-regulated chemokine was elevated in all 12 relapsed patients at time of relapse and remained elevated after salvage treatment in the 4 non-responsive patients. ConclusionsBaseline plasma thymus and activation-regulated chemokine levels correlate with classical Hodgkin's lymphoma tumor burden and serial levels correlate with response to treatment in patients with classical Hodgkin's lymphoma.Key words: Hodgkin's lymphoma, plasma thymus, chemokine, tumor burden, serial plasma. 's lymphoma. Haematologica 2012;97(3):410-415. doi:10.3324/haematol.2011 Citation: Plattel WJ, van den Berg A, Visser L, van der Graaf A-M, Pruim J, Vos H, Hepkema B, Diepstra A, and van Imhoff GW. Plasma thymus and activation-regulated chemokine as an early response marker in classical Hodgkin

Baseline serum TARC levels predict therapy outcome in patients with Hodgkin lymphoma

“…1B). Thus, the patient cohort presented here confirmed previous data from smaller cohorts [9][10][11].…”

“…Interestingly, elevated TARC levels were also reported for patients not responding to chemotherapy after treatment initiation [10]. A more recent study reported a significant decrease in TARC levels as early as after one cycle of chemotherapy in all responsive patients [11]. From a total of 60 patients, three were resistant to standard chemotherapy and only in these patients TARC levels failed to decrease [11].…”

“…Previous studies have shown that baseline TARC levels in newly diagnosed HL patients are significantly higher than in healthy controls and correlate well with disease stage [9][10][11] and metabolic activity assessed by positron-emission tomography (PET) [11]. Moreover, it was suggested that high TARC levels after therapy are associated with a poorer survival [9].…”

“…A more recent study reported a significant decrease in TARC levels as early as after one cycle of chemotherapy in all responsive patients [11]. From a total of 60 patients, three were resistant to standard chemotherapy and only in these patients TARC levels failed to decrease [11]. Thus, TARC might be a potential marker for an early response assessment.…”

Advances in the treatment of Hodgkin lymphoma

“…In addition to interim PET, biomarkers such as the thymus and activation-regulated chemokine (TARC), the number of CD68-positive macrophages in the tumor tissue or others might be included in a score predicting the individual patient's risk [17][18][19][20]. Furthermore, treatment could be optimized by combining conventional chemotherapy with novel targeted and less toxic drugs.…”