Interleukin 6 expression by Hodgkin/Reed–Sternberg cells is associated with the presence of ‘B’ symptoms and failure to achieve complete remission in patients with advanced Hodgkin's disease

Authors


Dr P. G. Murray, Department of Pathology, Division of Cancer Studies, The Medical School, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. E-mail: p.g.murray@bham.ac.uk

Abstract

Summary. Interleukin 6 (IL-6) is a potent immunomodulatory cytokine that has pathogenic and prognostic significance in a number of disorders. Previous studies in Hodgkin's disease (HD) have demonstrated the association between elevated serum levels of IL-6 and unfavourable prognosis, including advanced stage and the presence of ‘B’ symptoms and with reduced survival. Although IL-6 expression has been demonstrated in both the malignant Hodgkin/Reed–Sternberg (HRS) cells and in the various non-malignant cells present in HD biopsies, a relationship between expression of IL-6 by the tumour and outcome measures has not been established. The study group comprised of 97 patients with advanced HD who were recruited to two related clinical trials. IL-6 expression was determined on paraffin-wax sections of biopsy material by means of an immunohistochemical assay. Of the 97 patients, 27 (28%) showed staining for IL-6 in HRS cells. IL-6 expression by HRS cells was significantly correlated with a decreased likelihood of achieving a complete response to chemotherapy (P = 0·02) and with an increased prevalence of ‘B’ symptoms (P = 0·04). IL-6 expression by HRS cells was not associated with Epstein–Barr virus status (P = 0·57). In summary, the results suggest that IL-6 expression by HRS cells may contribute to the presence of ‘B’ symptoms and to a decreased likelihood to achieve a complete remission in HD patients.

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