Contributions
Abstract: EP768
Type: E-Poster Presentation
Session title: Hodgkin lymphoma - Clinical
Background
Classical Hodgkin lymphoma (cHL) accounts for 15% of all lymphoproliferative diseases, which is often presented with lymphadenopathy and B symptoms. The diagnosis of cHL is based on tissue sampling and histology, and the disease activity is monitored by serial PET/CT scans. cHL is considered to be highly curable, however substantial proportion of the patients suffer from refractory / relapsing disease. A reliable serum biomarker could support the management of these patients at the time of the diagnosis and later during the follow-up period. Thymus and Activation-Regulated Chemokine (TARC or CCL17) is highly expressed by Hodgkin and Reed-Sternberg cells and secreted into the serum, which raises the possibility to apply TARC as a tumor marker in cHL.
Aims
The aim of the study was to evaluate serum TARC as a reliable tumor marker in the course of treatment, and the follow up in patients with cHL.
Methods
Consecutive cases of cHL were enrolled in the study. In cohort 1 patients diagnosed between 2011 and 2018 were used to determine the cut off value of TARC. A second cohort of patients from 2019-2020 were used to validate the result. Serum TARC levels were determined with a quantitative sandwich enzyme immunoassay. Receiver Operating Characteristic (ROC) curve analysis was performed.
Results
In cohort 1, 613 patients diagnosed with cHL between 2011 and 2018 were enrolled. In 241 cases from this cohort, serum TARC concentrations were determined at baseline before therapy, as well. Receiver Operating Characteristic (ROC) curve analysis was performed for comparison with healthy controls (n=168). The cut-off value was found to be 637 pg/ml with 90.9% sensitivity and 98.2% specificity. During follow-ups measurements were carried out in 3 month intervals following diagnosis, and 6 month intervals after 3 years. The median serum TARC value was 14350 pg/ml in patients with active disease status. In cases with complete remission determined by PET/CT scans median TARC concentration was 401 pg/ml. ROC curve analysis of active versus complete remission groups showed 85.6% sensitivity and 93.7% specificity with a 936 pg/ml cut-off value. This result was used in the second half of the study: In cohort 2, 69 patients were enrolled who were consecutively diagnosed with cHL between 2019 and 2020. In this cohort 58 of 69 patients had TARC value above the cut off limit. In 2019 we treated 27 patients, and 23 of them had a positive TARC test result at baseline. At the end of the first line treatment 18 were in complete remission verified by PET/CT. More importantly all of these patient had a TARC value below 936 pg/ml.
Conclusion
Our results show that TARC is a robust and reliable tool in classical Hodgkin lymphoma both at diagnosis and for follow-up. The cut off values we found were similar to the previously published results. Measuring TARC can provide a sensitive method for treatment response assessment that can make the PET/CT based treatment protocols more effective.
Keyword(s): Chemokine, Diagnosis, Hodgkin's lymphoma, Remission
Abstract: EP768
Type: E-Poster Presentation
Session title: Hodgkin lymphoma - Clinical
Background
Classical Hodgkin lymphoma (cHL) accounts for 15% of all lymphoproliferative diseases, which is often presented with lymphadenopathy and B symptoms. The diagnosis of cHL is based on tissue sampling and histology, and the disease activity is monitored by serial PET/CT scans. cHL is considered to be highly curable, however substantial proportion of the patients suffer from refractory / relapsing disease. A reliable serum biomarker could support the management of these patients at the time of the diagnosis and later during the follow-up period. Thymus and Activation-Regulated Chemokine (TARC or CCL17) is highly expressed by Hodgkin and Reed-Sternberg cells and secreted into the serum, which raises the possibility to apply TARC as a tumor marker in cHL.
Aims
The aim of the study was to evaluate serum TARC as a reliable tumor marker in the course of treatment, and the follow up in patients with cHL.
Methods
Consecutive cases of cHL were enrolled in the study. In cohort 1 patients diagnosed between 2011 and 2018 were used to determine the cut off value of TARC. A second cohort of patients from 2019-2020 were used to validate the result. Serum TARC levels were determined with a quantitative sandwich enzyme immunoassay. Receiver Operating Characteristic (ROC) curve analysis was performed.
Results
In cohort 1, 613 patients diagnosed with cHL between 2011 and 2018 were enrolled. In 241 cases from this cohort, serum TARC concentrations were determined at baseline before therapy, as well. Receiver Operating Characteristic (ROC) curve analysis was performed for comparison with healthy controls (n=168). The cut-off value was found to be 637 pg/ml with 90.9% sensitivity and 98.2% specificity. During follow-ups measurements were carried out in 3 month intervals following diagnosis, and 6 month intervals after 3 years. The median serum TARC value was 14350 pg/ml in patients with active disease status. In cases with complete remission determined by PET/CT scans median TARC concentration was 401 pg/ml. ROC curve analysis of active versus complete remission groups showed 85.6% sensitivity and 93.7% specificity with a 936 pg/ml cut-off value. This result was used in the second half of the study: In cohort 2, 69 patients were enrolled who were consecutively diagnosed with cHL between 2019 and 2020. In this cohort 58 of 69 patients had TARC value above the cut off limit. In 2019 we treated 27 patients, and 23 of them had a positive TARC test result at baseline. At the end of the first line treatment 18 were in complete remission verified by PET/CT. More importantly all of these patient had a TARC value below 936 pg/ml.
Conclusion
Our results show that TARC is a robust and reliable tool in classical Hodgkin lymphoma both at diagnosis and for follow-up. The cut off values we found were similar to the previously published results. Measuring TARC can provide a sensitive method for treatment response assessment that can make the PET/CT based treatment protocols more effective.
Keyword(s): Chemokine, Diagnosis, Hodgkin's lymphoma, Remission