High serum levels of B-lymphocyte stimulator are associated with clinical-pathological features and outcome in classical Hodgkin lymphoma

B-lymphocyte stimulator (BLyS) acts as survival factor for B lymphocytes. AsHodgkin and Reed-Sternberg (HRS) cells express receptors through whichBLyS promotes their growth and chemotherapy resistance, we investgatedwhether this molecule was increased in sera from patients with classicalHodgkin lymphoma (cHL) and whether it correlates with clinicalpathologicalfeatures and outcomes. Enzyme-linked immunosorbent assaywas used to measure soluble BLyS (sBLyS) in sera from 87 patients and 33donors; higher levels were detected in patients (mean ± standard error4493.9 ± 264.9 pg/ml vs. 2687.0 ± 200.9 pg/ml; P < 0.0001). Levels abovethe median value (4242.0 pg/ml) were associated with age ≥45 years(P = 0.042), advanced stages of disease (P = 0.005), systemic symptoms(P = 0.014) and extranodal involvement (P = 0.009). Five-year failure-freesurvival (FFS) of patients with sBLyS below or equal to median levels was88.6% as compared to 65.1% of those with levels above the median(P = 0.009). Statistical analyses confirmed the prognostic significance ofsBLyS (P = 0.046). When patients were analysed according to variablesassociated with high levels, sBLyS showed an independent predictive power interms of FFS. Our findings support the involvement of BLyS in cHLpathogenesis. The association between high serum levels and an inferior FFSindicates that sBLyS is a possible prognostic predictor with a potentialsignificance as a therapeutic target