Journal of Clinical Oncology, Vol 16, 35-40, Copyright © 1998 by American Society of Clinical Oncology
Expression of the adhesion molecule ICAM-1 in non-Hodgkin's lymphoma: relationship with tumor dissemination and prognostic importance
MJ Terol, A Lopez-Guillermo, F Bosch, N Villamor, MC Cid, C Rozman, E Campo and E Montserrat
Postgraduate School of Hematology Farreras Valenti, and Department of Internal Medicine, Hospital Clinic of Barcelona, Spain.
PURPOSE: To study the expression of intercellular adhesion molecule-1
(ICAM-1) by non-Hodgkin's lymphomas and to assess its correlation with
disease extension and prognosis. PATIENTS AND METHODS: ICAM-1 (CD54- IOL54)
expression was studied in 70 patients (35 male/35 female; median age, 56
years) with non-Hodgkin's lymphoma from a single institution.
Immunostaining was performed using a streptavidine-biotin alkaline
phosphatase method and ICAM-1 expression was evaluated in a
semiquantitative manner. The histologic distribution of the cases was the
following: small lymphocytic, five cases; follicular, 14; mantle cell,
five; diffuse large cell, 41; and T lymphoblastic, five. Forty patients
(57%) were in stage IV, bulky disease was observed in 25 patients (36%),
and extranodal involvement in 48 patients (69%). RESULTS: ICAM-1 expression
was negative (-) in 14 patients (20%), weak (+) in 21 (30%), positive (++)
in 30 (43%), and strongly positive ( ) in five (7%). No significant
relationship was found between ICAM-1 expression and the lymphoma
histologic subtype. Patients with negative or weak ICAM-1 expression had
more frequently disseminated (stage IV) disease (74% v 40%; P = .007),
extranodal involvement (86% v 51%; P = .004), and bone marrow infiltration
(57% v 26%; P = .015) than the remainders. Positive ICAM-1 patients had
survival rates significantly better than those in whom ICAM-1 was negative
or weakly expressed [2- year overall survival: 77% v 50%, respectively; P
< .025]. In a multivariate study, ICAM-1 (P = .005) maintained, along
with histologic subtype (P = .001) and the international prognostic index
(IPI) (P = .056), its importance for predicting survival. Finally, when the
group of aggressive non-Hodgkin's lymphoma patients was analyzed, ICAM-1
expression inversely correlated with advanced stage (P = .025), extranodal
involvement (P = .01), and bone marrow infiltration (P = .01), complete
response (CR) achievement (65% v 32%; P = .025), and overall survival (70%
v 26% at 2 years; P < .005). CONCLUSION: In lymphoma patients, ICAM-1
expression correlates with lymphoma dissemination and is useful to assess
prognosis.
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