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sIL2R ratio as early marker for response in hairy cell leukemia and the prognostic relevance of IL28B genotype to interferon-α therapy

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Abstract

Interferon-α (IFNα) was the first effective drug therapy for hairy cell leukemia (HCL). Nowadays, it is used as an alternative treatment in selected patients. Due to unlimited treatment time, monitoring and early prediction of response are important. Moreover, IFNα is used in the therapy of chronic hepatitis C, where a single nucleotide polymorphism of interleukin-28B gene (IL28B) correlates with therapy response. The role of this polymorphism in therapy response of IFNα-treated patients with HCL is unknown. Thirty-seven HCL patients treated between 1978 and 2014 were included in this study. Treatment strategy and response parameters (blood cell counts, soluble interleukin-2 receptor (sIL2R), and bone marrow examination) have been assessed. Relative decrease of sIL2R was correlated with outcome parameters. Response parameters of IFNα-treated patients were correlated with IL28B polymorphism. Twenty-one patients were analyzed for the correlation of sIL2R ratio and outcome. After 1 and 3 months of therapy (IFNα or cladribine (CDA)), the median sIL2R level showed a relative decrease of 79 and 91%. These decreases significantly correlate with time to complete remission (CR, p = 0.029 and p = 0.018). Correlation analyses of IL28B genotype with outcome parameters are not significant. Six patients (16%) were diagnosed with secondary malignancies, and one death was registered (median follow-up time 14 years). IFNα is a safe, effective, and well-tolerated long-term treatment in HCL. Relative decreases of sIL2R levels correlate with time to CR and are useful as early predictor for response. There is no significant correlation between IL28B polymorphism and treatment response to IFNα.

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Authors’ contributions

SJ, RB, and JSG designed the study, acquisitated, and analyzed data and wrote the paper. KS performed the blood analysis. OS reviewed the data and supported the statistical analysis and interpretation. All the authors critically reviewed the article and gave final approval.

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Authors and Affiliations

  1. Departement of Hematology, University Hospital Zurich, Zurich, Switzerland

    Stéphanie Jud, Jeroen S. Goede & Markus G. Manz

  2. University of Zurich, Zurich, Switzerland

    Stéphanie Jud, Jeroen S. Goede, Oliver Senn & Markus G. Manz

  3. Kantonsspital Winterthur, Winterthur, Switzerland

    Jeroen S. Goede

  4. Departement of Clinical Chemistry, University Hospital Zurich, Zurich, Switzerland

    Katharina Spanaus

  5. Departement of Hematology, Kantonsspital Münsterlingen, Münsterlingen, Switzerland

    Rudolf Benz

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  1. Stéphanie Jud
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  2. Jeroen S. Goede
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  5. Markus G. Manz
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Correspondence to Stéphanie Jud.

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Jud, S., Goede, J.S., Senn, O. et al. sIL2R ratio as early marker for response in hairy cell leukemia and the prognostic relevance of IL28B genotype to interferon-α therapy. Ann Hematol 96, 757–763 (2017). https://doi.org/10.1007/s00277-017-2943-8

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  • DOI: https://doi.org/10.1007/s00277-017-2943-8

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