Hodgkin lymphoma can be diagnosed much earlier

It is possible to detect Hodgkin lymphoma early by using a simple blood test. This test identifies highly elevated levels of the specific protein TARC, that is secreted by Hodgkin's tumour cells. In fact, an increased amount of TARC protein can be detected three to six years prior to  diagnosis. This novel finding was revealed by research led by pathologist Arjan Diepstra of the UMCG. It indicates that Hodgkin lymphoma is a relatively slow-growing tumour that often exists for a long time before symptoms appear.
A. Diepstra

Hodgkin lymphoma is a form of cancer of the lymphatic system. In the Netherlands, about 500 patients are diagnosed with Hodgkin lymphoma every year. They receive treatment consisting of multiple cycles of chemotherapy, sometimes combined with radiotherapy. It is the most common form of cancer in young adults aged 18 to35.

Remarkable high amounts of TARC protein  at  diagnosis

The amount of TARC protein in the blood of Hodgkin patients at the time of diagnosis is on average about 400x higher than in healthy people. Its levels correlate well to the extent of disease and volume of tumour mass present. Current knowledge indicates that high TARC is a strong and specific predictor for presence of Hodgkin lymphoma.

Research with blood samples US  US Army

The research involved a collaboration with the Department of Defense Serum repository of the US Army which stores blood samples from active-duty military personnel. Within this healthy young adult cohort, 103 individuals developed Hodgkin lymphoma later on. The study found elevated TARC levels in the blood samples that were taken well before diagnosis.

Earlier diagnosis possible in future

According to Arjan Diepstra, the results of this study offer clues for earlier diagnosis in the future. 'The diagnosis of Hodgkin lymphoma relies on a biopsy of an enlarged lymph node. This is an invasive procedure and usually only done when a suspicion of lymphoma  is quite high. Indeed,  enlarged lymph nodes are more commonly due to infection than Hodgkin lymphoma. Measuring an elevated TARC in the blood could be a good reason to proceed to taking a biopsy. This is expected to help diagnose the disease earlier, perhaps even several months. An earlier diagnosis could increase the chances of cure, decrease the number of required cycles of  chemotherapy and improve quality of life. '

Frame text about this research:

The UMCG is a centre of expertise in the field of Hodgkin's lymphomal and does a lot of research in this area, with extensive collaboration between the departments of haematology (Wouter Plattel) and pathology/medical biology (Anke van den Berg, Lydia Visser and Arjan Diepstra). Through this collaboration, the protein TARC in Hodgkin was discovered and the clinical utility of measuring it in tissue and blood is becoming increasingly clear. Thus, there is already years of experience measuring TARC protein in blood of Hodgkin patients at diagnosis and during and after treatment with chemotherapy.

This study originated from a collaboration between researchers at UMCG and researchers affiliated with the US Army. Control blood samples were obtained from the same US Army biobank and statistical analysis was performed by the UMCG Epidemiology Department (Ilja Nolte). The study was published in the leading scientific journal Blood.UMCG researchers are continuing their research on TARC, including basic studies and several national and international clinical trials.