title: Influence of biologic markers on the outcome of Hodgkin's lymphoma: a study by the Spanish Hodgkin's Lymphoma Study Group.
abstract: OBJECTIVE
  Current therapies fail to cure a significant proportion of patients with Hodgkin's lymphoma (HL). Predictive systems for stratification of the disease and selection of treatment based on sets of clinical variables, such as the international prognostic score (IPS), are of relatively small practical value. The predictive use of biologic parameters has so far provided limited and inconsistent results. Here we explore the influence of a set of molecular markers on the outcome of HL.
  
  
  METHODS
  Forty molecular markers involved in B-cell differentiation and activation, signal transduction, cell cycle, and apoptosis control were analyzed in 259 classic HL patient cases by using tissue microarrays. Univariate analysis was performed to evaluate the influence of markers on favorable outcome (complete remission of > 12 months). Significant variables were included in a multivariate logistic regression analysis, and the probability of favorable outcome was estimated.
  
  
  RESULTS
  Univariate analysis revealed four molecular markers that predicted outcome, and the multivariate analysis showed p53, Bcl-X(L), and terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-biotin nick-end labeling (TUNEL) to have independent significance. The combination of these factors determined two groups of patients (group I, zero to one factor; group II, two to three factors) with a probability of a favorable outcome of.948 and.687, respectively. A multivariate Cox's model shows that these biologic risk groups have special predictive power in low-IPS patients.
  
  
  CONCLUSIONS
  The data from this exploratory study suggest that the accumulation of molecular events seems to influence the outcome of HL, particularly in the low-IPS group.
authors.affiliation: Medicina Interna, Hematología and Unidad de Bioestradistica Clínica, Hospital Ramón y Cajal, Madrid, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Montalbán
authors.forename: Juan F
authors.initials: JF
authors.lastname: García
authors.forename: Víctor
authors.initials: V
authors.lastname: Abraira
authors.forename: Leocricia
authors.initials: L
authors.lastname: González-Camacho
authors.forename: Manuel M
authors.initials: MM
authors.lastname: Morente
authors.forename: Jose L
authors.initials: JL
authors.lastname: Bello
authors.forename: Eulogio
authors.initials: E
authors.lastname: Conde
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Cruz
authors.forename: Ramón
authors.initials: R
authors.lastname: García-Sanz
authors.forename: José
authors.initials: J
authors.lastname: García-Laraña
authors.forename: Carlos
authors.initials: C
authors.lastname: Grande
authors.forename: Marta
authors.initials: M
authors.lastname: Llanos
authors.forename: Rafael
authors.initials: R
authors.lastname: Martínez
authors.forename: Eduardo
authors.initials: E
authors.lastname: Flores
authors.forename: Miguel
authors.initials: M
authors.lastname: Méndez
authors.forename: Concepción
authors.initials: C
authors.lastname: Ponderós
authors.forename: Concepción
authors.initials: C
authors.lastname: Rayón
authors.forename: Pedro
authors.initials: P
authors.lastname: Sánchez-Godoy
authors.forename: Javier
authors.initials: J
authors.lastname: Zamora
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Piris
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017209:Apoptosis; D014408:Biomarkers, Tumor / Q000032:analysis*; D002453:Cell Cycle; D002454:Cell Differentiation; D002648:Child; D005260:Female; D006689:Hodgkin Disease / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D020287:In Situ Nick-End Labeling; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis
chemical_list: D014408:Biomarkers, Tumor