Circulating Angiogenesis Factors in Patients with Non-Hodgkin’s Lymphoma

Aims: Non-Hodgkin’s lymphoma (NHL) is a heterogeneous group of hematological malignancies. Several angiogenic factors are important in NHL. The objective of this study was to determine plasma levels of various proangiogenic [vascular endothelial growth factor (VEGF), platelet derived growth factor (PDGF), tumor necrosis factor (TNF-α), transforming growth factor (TGF-β), interleukin (IL-6), IL-8] and antiangiogenic [IL-4, IL-12, interferon gamma (IFN-γ)] factors in NHL patients and implication of CHOP (cyclophosphamide, hydroxydaunorubicin, oncovin, prednisone) therapy on these mediators.
Study Design: This study was conducted on 100NHL patients recruited from the Oncology Hospital, Menofia University, Egypt. Fifty patients had different doses of CHOP chemotherapy and 50 patients were without treatment. Another 119 healthy blood donors were served as healthy controls.
Methodology: Enzyme-linked immunosorbent assay (ELISA) was used to detect the concentrations of these mediators in plasma of NHL patients and normal controls.
Results: Several proangiogenic (VEGF, PDGF, IL-8, and TNF-α) (P<.001, P<.01, P<.01, and P<.001) and antiangiogenic (IL-4,IL-12) (P=.05, P<.01) mediators were decreased in NHL patients. In contrast, IL-6, and IFN-γ) were increased (P<.001). After CHOP treatment, VEGF, and PDGF were significantly increased (P<.001) as compared to NHL without therapy Fig. 1. Reduction in IL-8 (P<.01) and TNF-α (P<.001) in untreated NHL patients was continued after CHOP treatment. IL-6 was the only elevated cytokine in NHL patients with (P<.001) or without (P<.001) treatment compared to healthy individuals. Concerning the antiangiogenic mediators, treatment resulted in reduction in the secretion level of IFN-γ) (P<.001) and IL-12 (P<.001). Although CHOP treatment required more than 8 doses to be able to down regulate proangiogenic (VEGF,PDGF, IL-8,TNF-α and IL-6) and elevate antiangiogenic (IL-4,IL-12,IFN-γ) mediators, changes were statistically insignificant.
Conclusion: Collectively, our study stressed on the importance of having an angiogenic profile of NHL patients under treatment which could be used to monitor the efficacy of cancer therapy particularly in therapy with antiangiogenic drugs. Further studies are required to confirm these results.