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

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 8^th 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 4^th 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 4^th cycle and the 8^th cycle of chemotherapy denoting that pretreatment serum level of IL- 10 is a good predictive marker of response.