The prognostic significance of CA 125 in patients with non-Hodgkin's lymphoma

Objective: To assess the association of serum CA 125 in patients with non-Hodgkin's lymphoma (NHL) with prognostic parameters of the disease, response to treatment, and survival. Patients and methods: Sixty-eight patients [38 males, median age 56 (range 17-82) yr] with NHL were evaluated. CA 125 was measured by an enzyme immunoradiometric assay at diagnosis and at the end of firstline treatment. Results: Median overall CA 125 was 49 (1-963) U mL(-1), whereas 49 patients had initially abnormal (> 35 U mL) CA 125 levels. High CA 125 was found to correlate with failure of treatment (P = 0.001) and relapse (P = 0.01), and to be independently associated with bulky disease, effusions, LDH, and the International Prognostic Index (IPI) score (P < 0.01 for each of these four variables). An initially abnormal CA 125 value was associated with poorer 5-yr survival [median survival of patients with CA 125> 35 U mL(-1) 33 (18-72) months compared to 58 (20-77) months for those with CA 125 = 35 U mL(-1), P = 0.012]. Moreover, CA 125> 35 U mL(-1) (among stage III/IV and LDH> 460 mU mL(-1)) emerged as an independent predictor of death within 5 yr from diagnosis (Relative Risk (RR) 3.1, 95% CI 1.5-12.8, P = 0.02). Conclusion: Measurement of serum CA 125 is useful for staging, monitoring, and estimating prognosis in patients with NHL.