Response of serum haptoglobin to hormone treatment and the relation of pretreatment values to mortality in patients with prostatic cancer

Abstract

Haptoglobin was measured in serum samples from prostatic cancer patients before and after three months of treatment with either Premarin, Provera, Provera and diethylstilbestrol, one of three doses of diethylstilbestrol, or placebo. Pretreatment haptoglobin levels were significantly elevated above levels observed in normal controls. Pretreatment levels in Study 2 patients were significantly lower than those in Study 3 patients. Levels in patients with stage III disease were significantly lower than in patients with stage IV disease in both studies. Thus, haptoglobin levels were related to extent and severity of disease. Haptoglobin levels were significantly correlated with the presence of metastases, fibrinogen and cortisol levels and negatively correlated with hemoglobin levels. Haptoglobin levels were decreased significantly by treatment with all of the estrogens but were unchanged or only modestly decreased by placebo or Provera treatment. Death rates were calculated by pretreatment haptoglobin levels for all treatments of all stage III and stage IV patients combined for Study 2 and Study 3 separately. Such rates were calculated for all causes combined and for deaths from prostatic cancer or cardiovascular disease separately. The levels of haptoglobin were significantly, positively correlated with death rates from all causes combined and with death rates from prostatic cancer but not with death rates from cardiovascular disease. The correlation between pretreatment haptoglobin levels and prostatic cancer death rates for Study 2 was r = .857,p ≤ .016 and for Study 3 r = .952,p ≤ .002. Patients with pretreatment levels above 285 mg/dl in Study 2 and above 330 mg/dl in Study 3 had three‐ and fivefold higher death rates than patients with levels In the normal range. The decreases following estrogen treatment were significantly linearly correlated with dose for the three dose levels of diethylstilbestrol. The amount of decrease in haptoglobin level after treatment was significantly dependent upon the initial haptoglobin level with higher levels exhibiting a greater decrease. This resulted in the average reduction of three months treatment to approximately normal levels. Cancer 42:1720–1729, 1978. Copyright © 1978 American Cancer Society