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Serum CA125: A Tumor Marker for Monitoring Response to Treatment and Follow-up in Patients with Non-Hodgkin’s Lymphoma

^a Oncology Unit, ^b Department of Internal Medicine, and ^c Otolaryngology Unit, Sieff Government Hospital, Safed, Israel; ^d Faculty of Medicine, Technion, Haifa, Israel

Correspondence: Jamal Zidan, M.D., Oncology Unit, Sieff Government Hospital, POB 1008, Safed, Israel. Telephone: 972-4-682-8951; Fax: 972-4-682-8621; e-mail: zidan.j{at}ziv.health.gov.il

Purpose. Serum CA125 is an important prognostic factor in patients with non-Hodgkin’s lymphoma (NHL). Elevation of CA125 level correlates with advanced disease, poor response to treatment, and poor survival rates. The aim of the current study is to evaluate CA125 levels in patients with NHL and to investigate the correlations between high CA125 level and other presenting features.

Materials and Methods. Thirty-eight patients (14 with low-grade and 24 with aggressive histologically proven NHL) were studied prospectively. Serum CA125 assessment was done at diagnosis, during treatment, and at follow-up. The associations between CA125 levels and other presenting features were examined.

Results. CA125 levels were elevated in 43% of patients with low-grade NHL and in 46% of patients with aggressive NHL (i.e., 45% of all patients). A higher CA125 level was associated with advanced disease, bone marrow involvement, extranodal involvement, poor performance status, the presence of B symptoms, and high serum lactate dehydrogenase level. Complete responses occurred in 86% of patients with normal CA125 levels and in 59% of patients with elevated CA125 levels. In both low-grade and aggressive NHL, the estimated 5-year overall survival rate was higher in patients with normal CA125 levels than in patients with elevated CA125 levels (88% versus 50% and 70% versus 27%, respectively).

Conclusion. High serum CA125 is an important prognostic factor in NHL and correlates with more advanced disease, low response rates, and worse survival. CA125 measurements may be used for staging, monitoring response to treatment, and follow-up of patients with NHL.

Key Words. Non-Hodgkin’s lymphoma • CA125 • Prognostic factor • Response • Survival