Tumor Markers in Diagnosis and Follow up of Haematologic Malignancies

Purpose: Τo estimate the incidence of abnormal values of tumor markers CA 15-3, CA125, CA19-9 and CEA at diagnosis and relapse/deterioration or remission of patients with hematological malignancies. Also, correlating them with the burden of disease at diagnosis and relapse/deterioration or remission of the above diseases.

Material-methods: Studied 268 patients, aged 16-95 years, who suffered from 14 hematological malignancies: myelodysplastic syndromes (MDS), idiopathic thrombocytosis, polycythemia vera, primary myelofibrosis, chronic myelogenous leukemia (CML), Hodgkin's and Non- Hodgkin's(NHL) lymphomas, chronic lymphocytic leukemia (CLL), multiple myeloma (M.M.), acute myelogenous leukemia (AML), acute lymphocytic leukemia (ALL), mastocytosis, hairy cell leukemia and hypereosinophilic syndrome. Tumor markers were determined by electrochemiluminescence immunoassay method, based on the principle of double immunofluorescence conducted by analyzer Hitachi Modular E170, subunit Elecsys.

Results: Tumor marker CA15-3 showed pathological values at diagnosis of hematological malignancies, except MDS and AML, which correlate with high disease burden at diagnosis of essential thrombocytosis(p <0,05), polycythemia vera(p <0.05) and NHL(p <0,001). Tumor marker CA125 had abnormal values at diagnosis of NHL and M.M, which correlate with high disease burden at diagnosis of NHL(p <0,01). CA19-9 and CEA showed no pathological values at diagnosis of hematological malignancies. CA15-3 showed pathological values at relapse/ deterioration of hematological malignancies, except for AML and ALL. These values correlate with the degree of relapse/deterioration of MDS(p <0,001), idiopathic thrombocytosis(p <0,01), lymphoma Hodgkin's(p <0,05), NHL(p <0,001) and CLL (p <0,01). CA125 showed pathological values at relapse/deterioration of M.M, NHL and CLL. These values correlate with the degree of relapse/deterioration of NHL(p <0,01) and CLL(p <0,05). CEA had pathological values at relapse/deterioration of M.M. CA19-9 had no significant findings at relapse/deterioration of hematological malignancies. Pathological values of CA15-3 decreased to normal levels during the remission of hematological malignancies, apart from MDS, primary myelofibrosis and AML. Decline of these values correlate with the degree of remission of Hodgkin's lymphomas(p <0,05), NHL(p <0,001), CLL(p <0,01) and idiopathic thrombocytosis (p <0,01). Pathological values of CA125 decreased to normal levels during the remission of M.M, NHL and CLL. Decline of these values correlate with the degree of remission of NHL(p <0,01) and CLL(p <0,05). CA19-9 and CEA had no significant findings at remission of hematological malignancies.

Conclusions: CA15-3 is a surrogate marker at diagnosis of hematological malignancies, other than MDS and AML. It can determine relapse/deterioration or remission in idiopathic thrombocytosis, MDS, NHL, Hodgkin's lymphomas and CLL. CA125 is a surrogate marker at diagnosis of NHL and M.M. It can determine relapse/deterioration or remission in NHL and CLL. CEA can help detect relapse/ deterioration in M.M. CA19-9 has no value in diagnosing and monitoring of hematological malignancies. Further studies in this area will likely bring new knowledge about tumor markers and their utility in current practice.