High serum interleukin-2 receptor levels are related to advanced disease and a poor outcome in childhood non-Hodgkin's lymphoma

The clinical usefulness of serum interleukin-2 receptor (IL2R) measurements was determined in 59 children with non-Hodgkin's lymphoma (NHL) and six with B cell acute lymphoblastic leukemia (B-ALL). Levels of the receptor showed a clear relationship to disease stage, as follows: B-ALL greater than stage III or IV diffuse small noncleaved-cell NHL greater than stage III or IV lymphoblastic NHL greater than stage I or II NHL. Soluble IL2R levels were also closely correlated with serum lactic dehydrogenase levels (r = 0.7, P = .0001), a recognized indicator of tumor cell burden. Children with higher soluble IL2R levels (greater than 1,000 U/mL) were significantly more likely to fail treatment (P = .001), even when the analysis was limited to those with more advanced disease: stages III and IV NHL and B-ALL (P = .02). In a multivariate analysis, soluble IL2R level was found to have greater predictive strength than either serum lactic dehydrogenase level or disease stage. Thus, the measurement of soluble IL2R in children with NHL could be expected to improve existing methods of risk assignment in this disease.