Hodgkin's Disease Clinical Trial
Official title:
Hodgkin's Lymphoma: Prognostic Value of the Kinetic of Decrease of 5 Cytokines Concentration During Treatment
More than 90% of patients with Hodgkin lymphoma (HL) can recover thanks to conventional
polychemotherapy regimens - ABVD or BEACOPP - with or without radiotherapy. Nevertheless,
some patients relapse and others are resistant to any treatment. These patients represent
2-5% of stage I / II and 5-10% of disseminated stages. The usual prognostic index based on
clinical and biological data (supradiaphragmatic HL: EORTC and advanced HL International
Prognostic Score) cannot always detect patients at risk.
New prognostic factors are required to screen out these high risk patients. Among available
biological factors, we will retain the cytokines secreted by tumor cells and cells from the
environment.
Indeed, the prognostic value of plasma cytokines levels and their soluble receptors has
recently been described by at least two teams. Olivier CASASNOVAS set up a prognostic index
based on quantities of IL-1 RA, IL-6, sCD30 and TNFR1 at diagnosis,and the V. Diehl team
published the prognostic value of the decrease of TARC (CC Thymus and Activation-related
chemokine).
In daily practice, the early assessment of response by PET CT-scan is now an undeniable
prognostic factor. Early identification of no-response or relapse is, in fact, based on
clinical and imaging (PET-CT scan).
We propose to evaluate the decrease of cytokines concentration with a prognostic value (TARC,
IL-6, IL1-RA, sCD30, TNFR1) as markers of response during treatment and during early
follow-up. The dosage of these cytokines will be paired with radiological assessments.
A correlation between the decrease of cytokines plasma levels overtime and event-free
survival will be searched afterwards.
To evaluate the decrease of cytokines concentration with a prognostic value as markers of
response, the dosage of TARC, IL-6, IL1-RA, sCD30 and TNFR1 will be performed during
treatment at :diagnosis, cycle 1 day 15, cycle 2 Day 1, cycle 3 Day 1, Day 1 of consolidation
(Cycle 5 day 1 or before radiotherapy) and evaluation of end of treatment.
an early follow-up with a dosage of cytokines will be performed 3 months after the end of
treatment.
An evaluation for Event Free Survival will be done at 3 years from diagnosis.
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