Thymidine kinase (TK) activity as a prognostic parameter of survival in lymphoma patients

A. Bogni, A. Cortinois, G. Grasselli, E. Seregni, F. Crippa, M. R. Castellani, E. Bombardieri

Research output: Contribution to journalArticlepeer-review


ATP-thymidine 5'-phosphotransferase (TK) is a cellular enzyme involved in DNA synthesis, activated during the G1/S phase of the cell cycle. Elevated TK serum levels can be found in cancer patients due to the active proliferation of tumor cells. TK serum activity was tested by a radioenzymatic technique (Prolifigen® TK REA, Sangtec Medical, Sweden) based on the conversion of 125 I deoxyuridine to 125 I deoxyuridine monophosphate. A total of 181 patients were enrolled in this study: 133 lymphomas (Hodgkin, HL and Non-Hodgkin, NHL) 48 benign diseases including acute (n = 17) and chronic inflammatory diseases (n = 13), myocardial infarction (n = 11), liver cirrhosis (n = 2), renal failures (n = 2), and diabetes (n = 3). Lymphoma patients were classified according to the Ann Arbor staging system, and 103 NHL patients were classified according to the Working Formulation histologic grade (21 low 72 intermediate, and 10 high grade lymphomas). The patients were treated with standard chemo-radiotherapeutic protocols according to the stage and the histologic grade; the evaluation of the response to the treatments and the follow-up were performed according to the serial examinations currently used in our Institute. Given a TK cut-off of 5 U/L, the diagnostic sensivity of TK test at lymphoma presentation was 81.8% and 75.7% in HL and NHL patients, respectively. Values exceeding 50 U/L were found only in NHL patients. The overall sensitivity of TK resulted higher than that of LDH (16.7%), copper (42.6%), IgG (23.5%), IgM (26.8%) and IgA (9.8%). TK values were also found to be correlated (p = 0.001) with histological grading according to the Working Formulation. TK showed a significant correlation with survival in all lymphoma patients and in NHL patients. Patients with TK activity below 5 U/L displayed a better survival than patients with higher values. A significant association with survival was also found for LDH values in all (p = 0.0002) and NHL (p = 0.002) patients. Finally, the pre-treatment TK levels had some predictive value for response to therapy. On the basis of these results serum TK activity determinations are of use to predict the clinical behaviour of lymphoma, and they can be considered as a valid prognostic indicator.

Original languageEnglish
Pages (from-to)121-125
Number of pages5
JournalJournal of Biological Regulators and Homeostatic Agents
Issue number4
Publication statusPublished - 1994


  • Hodgkin lymphomas
  • Non-Hodgkin lymphomas
  • Prognostic parameter
  • Thymidine kinase

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Endocrinology
  • Physiology
  • Immunology
  • Medicine (miscellaneous)
  • Endocrinology, Diabetes and Metabolism
  • Physiology (medical)


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