Background: Interleukin-15 (IL-15) has been associated with the growth, survival and biological behavior of leukemic cells and response to therapy. We determined the expression of IL-15 in lymphoblasts and evaluated its potential impact on the outcome in adult acute lymphoblastic leukemia (ALL).
Methods: Between June 1999 and June 2006, ALL samples were collected from 87 adult patients before initiation of antineoplastic therapy. These patients were enrolled in the German Multicenter Acute Lymphoblastic Leukemia June 1999 and July 2003 study trials. The expression of IL-15 in leukemic cells was analyzed by real-time polymerase chain reaction.
Results: The expression of IL-15 correlated with the immunophenotype: T-lineage ALL had a more than 4-fold higher IL-15 mRNA expression as compared with B-cell precursor (BCP)-ALL (P < .001). Patients with BCR-ABL(+)-BCP-ALL had lower IL-15 expression compared with BCR-ABL(-)-BCP-ALL (P = .041). Furthermore, higher expression of IL-15 was associated with mediastinal (P = .001) and lymph node infiltration (P = .051), but not with hepatomegaly and splenomegaly. Notably, high IL-15 expression in BCP-ALL was associated with an inferior relapse-free survival (RFS) at 5 years (0.17 +/- 0.13 vs 0.47 +/- 0.13) (P = .008), but there was no impact on overall survival (P = .249).
Conclusions: Differential expression of IL-15 in adult ALL at diagnosis was associated with clinical features and outcome, in particular, RFS. It remains to be evaluated whether IL-15 might be a relevant therapy target, or might be used for risk stratification.