Document 0145
 DOCN  M9470145
 TI    Significance of soluble interleukin-2 receptor levels for evaluation of
       the progression of adult T-cell leukemia.
 DT    9409
 AU    Kamihira S; Atogami S; Sohda H; Momita S; Yamada Y; Tomonaga M; Blood
       Transfusion Service, Nagasaki University Hospital, Japan.
 SO    Cancer. 1994 Jun 1;73(11):2753-8. Unique Identifier : AIDSLINE
       MED/94251714
 AB    BACKGROUND. The authors conducted a survey of a large cohort of patients
       with adult T-cell leukemia (ATL) and a group of human T-cell leukemia
       virus type 1 (HTLV-1) carriers to elucidate whether measurements of
       soluble interleukin-2 receptor (sIL-2R) levels are indicative of ATL
       tumor burden and correlate with clinical progression. METHODS. Using a
       sandwich enzyme immunoassay, the authors determined sIL-2R in the serum
       of 135 patients with ATL diagnosed and subclassified according to the
       Japan Lymphoma Study Group criteria and in the serum of healthy HTLV-1
       seropositive persons. Also included were patients in the preleukemic
       state of ATL (pre-ATL), which is characterized by only slight blood
       changes but does not fit the diagnostic criteria of ATL. In the five
       subjects who finally advanced to overt ATL, the authors prospectively
       performed serial measurements of the receptor. RESULTS. Serial
       measurements of sIL-2R levels taken until overt ATL developed showed
       that these levels in the initial samples were higher than those of
       control subjects, even when subjects were asymptomatic or in the pre-ATL
       state. The serial levels of the five subjects gradually increased
       despite being in a clinically stable condition, finally reaching
       markedly high levels at the time ATL became overt. The mean sIL-2R
       levels of the smoldering, chronic, acute, and lymphoma subtypes of ATL
       were 1680 U/ml, 6680 U/ml, 45,940 U/ml, and 34,620 U/ml, respectively (P
       < 0.01). The sIL-2R levels of each subtype at the time of diagnosis were
       more correlated with tumor burden, malignant behavior, and prognosis
       than lactate dehydrogenase (LDH) levels. In the low, moderate, and high
       sIL-2R subgroups, the median survival time and percent survival
       probability at 2 years was 30.2 months (46.0%), 16.5 months (25.0%), and
       7.7 months (15.3%), respectively. CONCLUSIONS. Serial measurements of
       sIL-2R levels are of clinical importance because changes of the levels
       correlate with disease progression, especially in early phase of ATL.
       The data suggest that sIL-2R may be more useful than LDH. In addition,
       emphasis may be placed on sIL-2R as an indicator of ATL progression
       status and prognosis for survival. The value of this marker in clinical
       practice should be confirmed prospectively.
 DE    Carrier State/PATHOLOGY  Human  HTLV-I Infections/PATHOLOGY
       Immunoenzyme Techniques  Leukemia-Lymphoma, T-Cell, Acute,
       HTLV-I-Associated/MORTALITY/  *PATHOLOGY  Middle Age
       Preleukemia/PATHOLOGY  Receptors, Interleukin-2/*ANALYSIS  Solubility
       Support, Non-U.S. Gov't  Survival Rate  JOURNAL ARTICLE

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