SERUM LEVELS OF SOLUBLE CD30 ARE ELEVATED IN THE MAJORITY OF UNTREATED PATIENTS WITH HODGKINS-DISEASE AND CORRELATE WITH CLINICAL-FEATURES AND PROGNOSIS

Purpose: To evaluate the serum levels of the soluble form of the CD30 molecule (sCD30) in patients with Hodgkin's disease (HD) to establish whether there is a correlation with clinical features at presentation and prognosis. Patients and Methods: The sCD30 serum levels of 117 patients were measured at diagnosis with a commercial sandwich enzyme-linked immunoadsorbent assay (ELISA) test kit, and in 78 of these patients the sCD30 levels were also recorded during the follow-up period. Results: sCD30 levels at diagnosis were increased (>20 U/mL) in a high proportion of patients (87.2%; mean ± SD, 108 ± 134 v 5.3 ± 5.7 U/mL in controls, P < .0001) and correlated with stage (stages I + II, 73 ± 97 U/mL; III + IV, 162 ± 165 U/mL; P < .0001), with presence of B symptoms (stage A, 69 ± 82 U/mL; stage B, 162 ± 171 U/mL; P < .0001), and, to some extent, with tumor burden (bulky presentation, 141 ± 129 U/mL; nonbulky, 91 ± 133 U/mL; P = .058). Patients with sCD30 levels greater than 100 U/mL at diagnosis had a significantly higher rate of poor outcome in terms of failure to achieve a complete remission (CR) or disease relapse after CR achievement. In fact, the event-free survival (EFS) duration of patients with sCD30 levels greater than 100 U/mL was significantly worse (P = .0016). Using multivariate analysis, an sCD30 level greater than 100 U/mL retained its significance after adjustment for other prognostic parameters. Conclusion: sCD30 in HD at presentation strictly correlates with clinical features. Serum levels greater than 100 U/mL at diagnosis entail a significantly higher risk of treatment failure, a factor that is independent of other prognostic parameters.