Serum IL- 10 As a Predictive Marker of Response to Chemotherapy in Advanced Stage Hodgkin Lymphoma

Abstract

Background: Cytokines and chemokines produced by HRS cells and the surrounding microenvironment are believed to be involved in the pathogenesis of HL by modulating immune functions and inflammatory responses. Among those cytokines; IL-10 seems to be most relevant for the shaping of a microenvironment favoring survival of HRS cells. Elevated IL-10 serum levels were even associated with a worse clinical outcome in patients with HL.The aim of this study is to show the prognostic and predictive relevance of serum IL10 in advanced stage HL.Patients and method: the study included 60 patients with advanced stage HL, treatment regimen was ABVD regimen (n=30) or BEACOPP baseline regimen (n=30). Serum IL10 assay employs the quantitative sandwich enzyme immunoassay technique. Evaluation of IL10 level was done at diagnosis then after 4 and 8 cycles of chemotherapy.Results: The median agewas 41 years (range 20-65), 37 males (61.7%) and 23 females (38.3 %) were included. For patients treated with ABVD regimen, complete response (CR) was achieved in 18 cases (60%) compared to a CR rate of 66.7% for the BEACOPP regimen (CR= 20 cases) P=0.6. There was no significant difference between both treatment regimens regarding PFS and DFS (p=0.6 and 0.9 respectively). High pretreatment serum IL10 (>10pg/ml) showed significant relation to high LDH (p=0.001), male sex (p=0.018), more advanced stage IV versus IIB and III (p=0.0001) and the IPI score of 4 or more for advanced HL. This study showed that 83.3% of the patients with pretreatment serum IL 10 ≤ 10 pg/ml achieved CR compared to 45.2% of patients with IL-10>10 pg/ml did not achieved CR after 8th cycle of chemotherapy with (P= 0.035), Also the patients who achieved CR after 8 cycles had low level of IL-10 after treatment with a median of 9.35pg/ml (range 5.49-73.16) compared to a median of 30.66 (range 5.36-145.6) for patients who did not show CR (P<0.001). This significant relation between the CR rate and serum IL10 before and after treatment was also documented after the 4th cycles of chemotherapy (p=.006 and 0.003respectively). Our study found no significant relation between the IL-10 level prior to therapy and occurrence of relapse, disease progression or mortality.Conclusion: There is a significant relations between high pretreatment serum level of IL-10 with poor response to chemotherapy after the 4th cycle and the 8th cycle of chemotherapy denoting that pretreatment serum level of IL- 10 is a good predictive marker of response. DisclosuresNo relevant conflicts of interest to declare.