Plasma soluble interleukin‐2 receptor level in patients with primary myelodysplastic syndromes: a relationship with disease subtype and clinical outcome

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Abstract
To assess the hypothesis that the plasma soluble interleukin‐2 receptor (sIL‐2R) level may have predictive value for morbidity/mortality in patients with myelodysplastic syndromes (MDS), we determined the plasma sIL‐2R level of 80 MDS patients and examined their subsequent clinical course. Compared with low‐risk MDS (refractory anaemia (RA) and RA with ringed sideroblasts) patients and normal subjects, the plasma sIL‐2R level was significantly elevated in high‐risk MDS (three other MDS subtypes and acute leukaemia following MDS) patients (high‐risk MDS versus low‐risk MDS, P < 0.01; high‐risk MDS versus normal subjects, P < 0.01). 14/40 low‐risk MDS patients developed at least one of the following during the follow‐up period: erythrocyte transfusion dependence, infections requiring hospitalization, disease progression or MDS‐related death. The plasma sIL‐2R level was higher in these eventful subjects than in event‐free low‐risk subjects (P < 0.0001), and all of 10 low‐risk subjects with a plasma sIL‐2R level > 540 U/ml experienced at least one event. By logistic regression analysis of various parameters in these 40 low‐risk subjects, the plasma sIL‐2R level was identified as the strongest independent parameter for predicting eventful subjects (P < 0.0047). The plasma sIL‐2R level did not show a predictive value in high‐risk MDS. This study revealed that the plasma sIL‐2R level is significantly elevated in high‐risk MDS and suggested that the plasma sIL‐2R level is a valuable predictive factor for the clinical outcome in low‐risk MDS.

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