However, serum proangiogenetic markers are a simple method and have the considerable advantage selleck chemicals llc of not requiring an experienced pathologist to reliably assess. There have been only a few published studies on these serum proangiogenetic markers in clinical settings. However, confounding variables of known clinical prognostic factors were not considered in some of these reports. Therefore, we conducted this study to determine the independent association between these markers and clinical outcomes.In earlier studies, Salven et al. [12�C14] and Bertolini et al. [15] demonstrated a significant association between these markers and the outcomes of patients with NHL in concordance with our study. The correlation between high VEGF levels and poor CR rate also supported the hypothesis that high VEGF is responsible for an abnormal vessel structure of tumors leading to lowering drug delivery [4].

However, our more recent study found higher levels of pretreatment VEGF and bFGF, probably because the patients in our study had more advanced stages of disease. Ribatti et al. [16] and Crivellato et al. [17] also found that neovascularization was found frequently in high-grade lymphoma. The different serum VEGF and bFGF levels before treatment in patients with different degrees of disease, or due to other factors, may lead to difficulty in obtaining a single cut-off value for a predictor in all patients with NHL. In addition, the level of bFGF may be elevated due to other conditions associated with increased endothelial activity, infection, or inflammation [18, 19].

Importance roles of angiogenesis in lymphomas Cilengitide have been demonstrated in clinical studies. Tzankov and colleagues [20] performed immunohistochemical and morphometric studies in B-cell lymphomas and found higher microvessel density, and VEGF and COX2 in aggressive lymphomas. This result is in concordance with Ganjoo et al. [21] who reported that patients with negative stained VEGF-A or VEGF-R1 had a superior survival rate. These studies confirmed the potential importance of increased angiogenesis in prognosis and tracking of disease progression in non-Hodgkin lymphomas. In conclusion, our study suggests that serum VEGF and bFGF are associated with poor prognosis in patients with de novo non-Hodgkin lymphomas. Further studies are needed to determine more clearly whether monitoring of consecutive levels of these molecules during or after therapy could predict CR or relapse. In addition, these markers may play an important role in patient selection for antiangiogenetic treatment.AcknowledgementsThe authors are indebted to Ms. Somporn Sretrirutchai for her technical assistance.