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Clinical and Prognostic Implications

Mariusz A. Wasik, MD; Eric C. Vonderheid, MD; Robert D. Bigler, MD; Rosa Marti, MD; Stuart R. Lessin, MD; Marcia Polansky, ScD; Marshall E. Kadin, MD

Arch Dermatol. 1996;132(1):42-47.

Abstract
Background and Design
The serum concentration of soluble -chain receptor for interleukin-2 (sIL-2R) was determined in 101 patients with cutaneous T-cell lymphoma (CTCL).

Results
The serum concentration of sIL-2R correlates positively with CTCL tumor burden as determined by several clinical parameters (ie, clinical subtype of disease, extent of skin involvement, T rating, and stage), by serum lactate dehydrogenase concentration, and by Sézary cell counts in erythrodermic disease. The median value of sIL-2R in erythrodermic CTCL was more than threefold higher than that of classic mycosis fungoides (MF). The proportion of patients with elevated sIL-2R concentration (>1000 U/mL) also increased in CTCL in a similar fashion according to the clinical type of disease (MF patch phase, 15%; MF plaque phase, 33%; MF tumor phase, 47%; and erythrodermic variants, 90%). However, no correlation was found between sIL-2R serum concentration and expression of membrane-bound IL-2R chain (CD25) on lymphoid cells in skin lesions and peripheral blood. Significantly, multivariate analysis of various prognostic factors demonstrated that in erythrodermic CTCL, sIL-2R serum concentration correlated best with survival and was a better predictor of prognosis than stage, Sézary cell counts, or lactate dehydrogenase values.

Conclusions
These findings document the usefulness of the measurement of the sIL-2R serum concentration to determine tumor burden and prognosis in patients with CTCL.

(Arch Dermatol. 1996;132:42-47)

Author Affiliations
From the Department of Pathology, Beth Israel Hospital and Harvard Medical School, Boston, Mass (Drs Wasik, Marti, and Kadin); the Departments of Dermatology (Dr Vonderheid) and Medicine (Drs Bigler and Polansky), Hahnemann University, Philadelphia, Pa; and the Departments of Dermatology, Universitat de Lleida, Lleida, Spain (Dr Marti), and University of Pennsylvania Medical Center, Philadelphia (Dr Lessin). Dr Wasik is now with the Department of Pathology and Laboratory Medicine, University of Pennsylvania Medical Center.

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