- Volume 7
- Issue 6 Publication Date: May 2007
Elevated Vascular Endothelial Growth Factor Pretreatment Levels Are Correlated with the Tumor Burden in Hodgkin Lymphoma and Continue to Be Elevated in Prolonged Complete Remission
Antonio Rueda, David Olmos, Vicente Villareal, Esperanza Torres, Bella Isabel Pajares, Emilio Alba
Background: Vascular endothelial growth factor (VEGF) has been described as an essential cytokine in the regulation of angiogenesis. Its elevation in peripheral blood or bone marrow has been associated with an unfavorable outcome in different hematologic neoplasms. Hodgkin lymphoma represents approximately one fifth of all lymphomas, and the roles of angiogenesis and VEGF in Hodgkin lymphoma have not been well defined at present. Patients and Methods: Vascular endothelial growth factor serum levels were determined by enzyme-linked immunosorbent assay in 54 newly diagnosed patients, 26 patients in prolonged complete remission (CR), and 54 healthy controls. Vascular endothelial growth factor levels were compared among the different populations and correlated with prognostic factors and disease evolution. Results: Newly diagnosed patients showed an increase in VEGF level compared with the CR subgroup (549 pg/mL vs. 327.5 pg/mL; P = 0.023) and with healthy controls (549 pg/mL vs. 140 pg/mL; P < 0.001). Patients in CR also showed an elevated VEGF with respect to healthy controls (327.5 pg/mL vs. 140 pg/mL; P = 0.01). Elevated VEGF was also statistically correlated with newly diagnosed patients with a greater tumor burden (594.5 pg/mL vs. 391 pg/mL; P = 0.009), with ≥ 4 involved areas (608 pg/mL vs. 507 pg/mL; P = 0.036), and with an Eastern Cooperative Oncology Group performance status of ≥ 1 (812 pg/mL vs. 447 pg/mL; P = 0.005). Vascular endothelial growth factor was also elevated in advanced-stage disease, in patients with B symptoms, and poor-risk groups, but none of them became statistically significant. Conclusion: Pathologic angiogenesis is an activated pathway in Hodgkin lymphoma and participates in Hodgkin lymphoma progression. This has been shown by an elevated VEGF level in patients: before first treatment, with greater tumor burden, and with a higher number of involved areas. Furthermore, VEGF continues to be elevated in patients with Hodgkin lymphoma after prolonged CR.