Introduction: Soluble interleukin-2 receptor (sIL-2R) is well known as a disease marker of systemic malignant lymphomas. However, clinical significance of sIL-2R in primary central nervous system lymphoma (PCNSL) is still unclear. We investigated relationships between serum sIL-2R or other clinical values and the prognosis in patients with PCNSL.
Methods: The patients were 21 men and 22 women, mean age 66.5y, treated in our hospital from November 2002 to March 2014. Mean follow-up period was 17.4 months ranging from one to 122 months. For the statistical analysis, the patients were grouped by the age (cut off: 70y), Karnofsky performance status (KPS. cut off; 70), the serum level of sIL-2R (cut off: 550IU/mL), LDH (cut off: 220U/mL) and standardized uptake value (SUVmax. cut off: 12) measured by 2-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) as tumor aggressiveness before the treatment.
Results: The serum level of sIL-2R was not affected by the age, but elevated in lower KPS group (p=0.0457). Serum level of sIL-2R and LDH related neither FDG uptake nor survival.
Kaplan-Meier analysis exhibited higher uptake on FDG-PET associated with poor survival (p=0.0186), and mild tendencies of poor survival among the aged-population (p=0.1854) and lower KPS group (p=0.2822). Our results indicated sIL-2R had no prognostic impact but some relationship to the patient condition.
Conclusions: Our study illustrates the serum level of sIL-2R reflects poorer systemic and/or neurological condition that might lead to worse prognosis. SUVmax in FDG-PET related to the patient survival.
Patient Care: It would be useful for the evaluation of systemic/neurological condition of PCNSL patients. The measurement of sIL-2R level would be an aid to forecast systemic relapse of lymphoma.
Learning Objectives: By the conclusion of this session, participants should be able to:
1) Explain knowledge about sIL-2R and clinical applications of its measurement.
2) Judge how systemic and/or neurological condition in patients with PCNSL impacts on their prognoses.
3) Compare and contrast the usefulness and implication of sIL-2R and FDG-PET for predicting the prognosis of PCNSL.
References: Kawai N, Zhen HN, Miyake K, Yamamaoto Y, Nishiyama Y, Tamiya T.
Prognostic value of pretreatment 18F-FDG PET in patients with primary central nervous system lymphoma: SUV-based assessment. J Neurooncol. 2010 Nov; 100(2):225-32.