Annals of Hematology

, Volume 96, Issue 5, pp 757–763 | Cite as

sIL2R ratio as early marker for response in hairy cell leukemia and the prognostic relevance of IL28B genotype to interferon-α therapy

  • Stéphanie Jud
  • Jeroen S. Goede
  • Oliver Senn
  • Katharina Spanaus
  • Markus G. Manz
  • Rudolf Benz
Original Article


Interferon-α (IFNα) was the first effective drug therapy for hairy cell leukemia (HCL). Nowadays, it is used as an alternative treatment in selected patients. Due to unlimited treatment time, monitoring and early prediction of response are important. Moreover, IFNα is used in the therapy of chronic hepatitis C, where a single nucleotide polymorphism of interleukin-28B gene (IL28B) correlates with therapy response. The role of this polymorphism in therapy response of IFNα-treated patients with HCL is unknown. Thirty-seven HCL patients treated between 1978 and 2014 were included in this study. Treatment strategy and response parameters (blood cell counts, soluble interleukin-2 receptor (sIL2R), and bone marrow examination) have been assessed. Relative decrease of sIL2R was correlated with outcome parameters. Response parameters of IFNα-treated patients were correlated with IL28B polymorphism. Twenty-one patients were analyzed for the correlation of sIL2R ratio and outcome. After 1 and 3 months of therapy (IFNα or cladribine (CDA)), the median sIL2R level showed a relative decrease of 79 and 91%. These decreases significantly correlate with time to complete remission (CR, p = 0.029 and p = 0.018). Correlation analyses of IL28B genotype with outcome parameters are not significant. Six patients (16%) were diagnosed with secondary malignancies, and one death was registered (median follow-up time 14 years). IFNα is a safe, effective, and well-tolerated long-term treatment in HCL. Relative decreases of sIL2R levels correlate with time to CR and are useful as early predictor for response. There is no significant correlation between IL28B polymorphism and treatment response to IFNα.

Graphical abstract


Hairy cell leukemia IL28B polymorphism Interferon-alpha Soluble interleukin-2 receptor Cladribine 


Authors’ contributions

SJ, RB, and JSG designed the study, acquisitated, and analyzed data and wrote the paper. KS performed the blood analysis. OS reviewed the data and supported the statistical analysis and interpretation. All the authors critically reviewed the article and gave final approval.

Compliance with ethical standards

Conflicts of interest

The authors declare that they have no conflict of interest.

Supplementary material

277_2017_2943_MOESM1_ESM.docx (144 kb)
ESM 1 (DOCX 144 kb)


  1. 1.
    Campo E, Swerdlow SH, Harris NL et al (2011) The 2008 WHO classification of lymphoid neoplasms and beyond: evolving concepts and practical applications. Blood 19:5019–5032CrossRefGoogle Scholar
  2. 2.
    Bouroncle BA, Wiseman BK, Doan CA (1958) Leukemic reticuloendotheliosis. Blood 13:609–630PubMedGoogle Scholar
  3. 3.
    Smith A, Howell D, Patmore R et al (2011) Incidence of haematological malignancy by sub-type: a report from the haematological malignancy research network. Br J Cancer 105:1684–1692CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Grever MR (2010) How I treat hairy cell leukemia. Blood 115:21–28CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Bouroncle BA (1979) Leukemic reticuloendotheliosis (hairy cell leukemia). Blood 53:412–436PubMedGoogle Scholar
  6. 6.
    Jones G, Parry-Jones N, Wilkins B et al (2012) Revised guidelines for the diagnosis and management of hairy cell leukaemia and hairy cell leukaemia variant. Br J Haematol 156:186–195CrossRefPubMedGoogle Scholar
  7. 7.
    Arcaini L, Zibellini S, Boveri E et al (2012) The BRAF V600E mutation in hairy cell leukemia and other mature B-cell neoplasms. Blood 119:188–191CrossRefPubMedGoogle Scholar
  8. 8.
    Chandran R, Gardiner SK, Smith SD et al (2013) Improved survival in hairy cell leukaemia over three decades: a SEER database analysis of prognostic factors. Br J Haematol 163:407–409CrossRefPubMedGoogle Scholar
  9. 9.
    Grever M, Kopecky K, Foucar MK et al (1995) Randomized comparison of pentostatin versus interferon alfa-2a in previously untreated patients with hairy cell leukemia: an intergroup study. J Clin Oncol 13:974–982CrossRefPubMedGoogle Scholar
  10. 10.
    Maevis V, Mey U, Schmidt-Wolf G et al (2014) Hairy cell leukemia: short review, today's recommendations and outlook. Blood Cancer J 4:e184CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Robak T, Matutes E, Catovsky D et al (2015) Hairy cell leukaemia: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 26:v100–v107CrossRefPubMedGoogle Scholar
  12. 12.
    Dietrich S, Pircher A, Endris V et al (2016) BRAF inhibition in hairy cell leukemia with low-dose vemurafenib. Blood 127:2847–2855CrossRefPubMedGoogle Scholar
  13. 13.
    Kreitman RJ, Tallman MS, Robak T et al (2012) Phase I trial of anti-CD22 recombinant immunotoxin moxetumomab pasudotox (CAT-8015 or HA22) in patients with hairy cell leukemia. J Clin Oncol 30:1822–1828CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Nyalakonda H, Utay NS (2015) A new era of therapy for hepatitis C virus infection. Curr Opin Infect DisGoogle Scholar
  15. 15.
    Fried MW, Shiffman ML, Reddy KR et al (2002) Peginterferon alfa-2a plus ribavirin for chronic hepatitis C virus infection. N Engl J Med 347:975–982CrossRefPubMedGoogle Scholar
  16. 16.
    Ge D, Fellay J, Thompson AJ et al (2009) Genetic variation in IL28B predicts hepatitis C treatment-induced viral clearance. Nature 461:399–401CrossRefPubMedGoogle Scholar
  17. 17.
    Lauria F, Rondelli D, Raspadori D et al (1992) Serum soluble interleukin-2 receptor levels in hairy cell leukemia: correlation with clinical and hematological parameters and with alpha-interferon treatment. Leuk Lymphoma 7:103–107CrossRefPubMedGoogle Scholar
  18. 18.
    Richards JM, Mick R, Latta JM et al (1990) Serum soluble interleukin-2 receptor is associated with clinical and pathologic disease status in hairy cell leukemia. Blood 76:1941–1945PubMedGoogle Scholar
  19. 19.
    Benz R, Siciliano RD, Stussi G et al (2009) Long-term follow-up of interferon-alpha induction and low-dose maintenance therapy in hairy cell leukemia. Eur J Haematol 82:194–200CrossRefPubMedGoogle Scholar
  20. 20.
    (2013) World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. Jama ;310:2191–2194Google Scholar
  21. 21.
    USZ (2014) Laktat Dehydrogenase (LDH). UniversitätsSpital Zürich, ZürichGoogle Scholar
  22. 22.
    Else M, Dearden CE, Matutes E et al (2009) Long-term follow-up of 233 patients with hairy cell leukaemia, treated initially with pentostatin or cladribine, at a median of 16 years from diagnosis. Br J Haematol 145:733–740CrossRefPubMedGoogle Scholar
  23. 23.
    Common Terminology Criteria for Adverse Events (CTCAE) (2009) U.S.Departement of health and human services. National Cancer Institute, USAGoogle Scholar
  24. 24.
    Golomb HM, Catovsky D, Golde DW (1978) Hairy cell leukemia: a clinical review based on 71 cases. Ann Intern Med 89:677–683CrossRefPubMedGoogle Scholar
  25. 25.
    Somasundaram V, Purohit A, Aggarwal M et al (2014) Hairy cell leukemia: a decade long experience of north Indian hematology center. Indian J Med Paediatr Oncol 35:271–275CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Bouafia F, Drai J, Bienvenu J et al (2004) Profiles and prognostic values of serum LDH isoenzymes in patients with haematopoietic malignancies. Bull Cancer 91:E229–E240PubMedGoogle Scholar
  27. 27.
    Mhawech-Fauceglia P, Oberholzer M, Aschenafi S et al (2006) Potential predictive patterns of minimal residual disease detected by immunohistochemistry on bone marrow biopsy specimens during a long-term follow-up in patients treated with cladribine for hairy cell leukemia. Arch Pathol Lab Med 130:374–377PubMedGoogle Scholar
  28. 28.
    Sharafi H, Pouryasin A, Alavian SM et al (2012) Distribution of IL28B genotypes in Iranian patients with chronic hepatitis C and healthy individuals. Hepat Mon 12:e8387PubMedPubMedCentralGoogle Scholar
  29. 29.
    Gelinas JF, Fabre T, Willems P et al (2013) IL28B SNP screening and distribution in the French Canadian population using a rapid PCR-based test. Immunogenetics 65:397–403CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Hisada M, Chen BE, Jaffe ES et al (2007) Second cancer incidence and cause-specific mortality among 3104 patients with hairy cell leukemia: a population-based study. J Natl Cancer Inst 99:215–222CrossRefPubMedGoogle Scholar
  31. 31.
    Federico M, Zinzani PL, Frassoldati A et al (2002) Risk of second cancer in patients with hairy cell leukemia: long-term follow-up. J Clin Oncol 20:638–646CrossRefPubMedGoogle Scholar
  32. 32.
    Gisslinger H, Zagrijtschuk O, Buxhofer-Ausch V et al (2015) Ropeginterferon alfa-2b, a novel IFNalpha-2b, induces high response rates with low toxicity in patients with polycythemia vera. Blood 126:1762–1769CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Jain P, Pemmaraju N, Ravandi F (2014) Update on the biology and treatment options for hairy cell leukemia. Curr Treat Options in Oncol 15:187–209CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  1. 1.Departement of HematologyUniversity Hospital ZurichZurichSwitzerland
  2. 2.University of ZurichZurichSwitzerland
  3. 3.Kantonsspital WinterthurWinterthurSwitzerland
  4. 4.Departement of Clinical ChemistryUniversity Hospital ZurichZurichSwitzerland
  5. 5.Departement of HematologyKantonsspital MünsterlingenMünsterlingenSwitzerland

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