title: Adverse prognostic significance of CD20 positive Reed-Sternberg cells in classical Hodgkin's disease.
abstract: The prognostic significance of CD20 positive classical Hodgkin's disease (cHD) is uncertain. All cHD cases referred to the Memorial Sloan-Kettering Cancer Center (MSKCC) were retrospectively identified (5/92-11/00); the samples were immunostained, and clinical data ascertained. Cases were re-reviewed without knowledge of clinical outcome. Univariate and multivariate analyses were performed 248 patients had cHD: 28 CD20(+) (11%); 220 CD20(-). All clinical characteristics were comparable except haemoglobin level at presentation. With a median follow-up of 29.2 months, significant prognostic factors in multivariate analysis were: CD20 positivity, elevated white blood cell count (WBC) and low absolute lymphocyte count for time-to treatment failure (TTF); and for overall survival (OS), CD20 positivity, elevated WBC count, bone marrow involvement and age >/=45 years. TTF was significantly poorer for ABVD-treated patients with CD20(+) cHD as compared with CD20(-) cHD. Among 167 patients treated at MSKCC, both TTF (P < 0.0001) and OS (P = 0.017) were significantly decreased in CD20(+) patients as compared with CD20(-) cHD. CD20(+) cHD is a poor prognostic factor for TTF and OS. All cHD cases should be immunophenotyped for CD20. A large prospective trial is needed to confirm these findings.
authors.affiliation: Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, USA. portlocc@mskcc.org
authors.forename: Carol S
authors.initials: CS
authors.lastname: Portlock
authors.forename: Gerard B
authors.initials: GB
authors.lastname: Donnelly
authors.forename: Jing
authors.initials: J
authors.lastname: Qin
authors.forename: David
authors.initials: D
authors.lastname: Straus
authors.forename: Joachim
authors.initials: J
authors.lastname: Yahalom
authors.forename: Andrew
authors.initials: A
authors.lastname: Zelenetz
authors.forename: Ariela
authors.initials: A
authors.lastname: Noy
authors.forename: Owen
authors.initials: O
authors.lastname: O'Connor
authors.forename: Steven
authors.initials: S
authors.lastname: Horwitz
authors.forename: Craig
authors.initials: C
authors.lastname: Moskowitz
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Filippa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018951:Antigens, CD20 / Q000032:analysis*; D015415:Biomarkers / Q000032:analysis; D005260:Female; D006689:Hodgkin Disease / Q000276:immunology*; D006801:Humans; D016130:Immunophenotyping; D007958:Leukocyte Count; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D016539:Reed-Sternberg Cells / Q000276:immunology*; D015996:Survival Rate
chemical_list: D018951:Antigens, CD20; D015415:Biomarkers