Objective: To explore the levels of serum soluble tumor necrosis factor receptors (sTNFRs) and the relationships with clinical situation, chemotherapeutic effects and TNF alpha level in acute leukemia (AL) patients.
Methods: Serum levels of sTNFRs and TNF alpha were measured by ELISA. Six parameters which might influence therapeutic effects were analyzed by logistic regression.
Results: 1. Serum levels of sTNFR I and sTNFR II in 31 untreated AL patients were significantly higher than those in controls(P < 0.001 and < 0.005, respectively) and in bone marrow remission (BMR) AL patients (P < 0.005 and < 0.05, respectively). The levels of sTNFR I and sTNFR II in 11 relapsed/refractory AL patients were significantly higher than those in controls(P < 0.001 and < 0.05, respectively), but were not different from those in untreated AL patients. 2. Serum levels of sTNFR I in untreated ALL patients were significantly higher than those in ANLL patients (P < 0.05). 3. High levels of serum sTNFR I were more common in patients with high leukocyte count(> or = 100 x 10(9)/L) and high levels of serum sTNFR II were more common in patients with splenomegaly. Levels of the two sTNFRs positively correlated with blasts in peripheral blood (P < 0.001 and < 0.05, respectively). 4. The level of TNF alpha in 31 untreated AL patients significantly correlated with the level of sTNFR I (r = 0.440, P < 0.05). 5. The BMR rate was higher in those serum sTNFR I level < 2.0 micrograms/L than in those > or = 2.0 micrograms/L(P < 0.05). 6. Of the six parameters which might influence AL therapeutic effects, only sTNFR I < 2.0 micrograms/L was predictive.
Conclusion: High levels of serum sTNFRs in AL patients might be derived from leukemic cells and predicted an adverse prognosis.