title: MAL is expressed in a subset of Hodgkin lymphoma and identifies a population of patients with poor prognosis.
abstract: Classical Hodgkin lymphoma (cHL) and mediastinal (thymic) large B-cell lymphoma (MLBL) have clinical, histopathologic, and molecular genetic similarities. MAL, a gene that encodes a protein associated with lipid rafts in T and epithelial cells, is overexpressed in a majority of MLBLs and has been reported in a minority of cHLs. To study the clinical significance of MAL in cHL, we immunostained 86 cases; 16 cHLs (19%) expressed MAL. Expression correlated with nodular sclerosis subtype, and within this subtype, with grade 2 histology. Univariable analysis revealed association of age of 45 years or older, MAL expression, and an International Prognostic Score of more than 2 with worse failure-free survival. Age of 45 years or older, MAL expression, and stage III or IV were associated with worse overall survival (OS). Cox proportional hazards modeling showed age (P = .04 and P = .03, respectively) and MAL expression (P = .03 and P = .01, respectively) as independent predictors of time to failure-free survival and OS. Stage showed borderline significance in OS (P = .08). MAL expression seems to identify a subset of cHL with an adverse outcome and provides additional evidence for a link between cHL and MLBL.
authors.affiliation: Department of Clinical Pathology, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
authors.forename: Eric D
authors.initials: ED
authors.lastname: Hsi
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Sup
authors.forename: Carlos
authors.initials: C
authors.lastname: Alemany
authors.forename: Elisa
authors.initials: E
authors.lastname: Tso
authors.forename: Marek
authors.initials: M
authors.lastname: Skacel
authors.forename: Paul
authors.initials: P
authors.lastname: Elson
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Alonso
authors.forename: Brad
authors.initials: B
authors.lastname: Pohlman
mesh_terms: D000328:Adult; D014408:Biomarkers, Tumor / Q000378:metabolism; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006689:Hodgkin Disease / Q000175:diagnosis* / Q000378:metabolism* / Q000401:mortality / Q000628:therapy; D006801:Humans; D007150:Immunohistochemistry; D016393:Lymphoma, B-Cell / Q000175:diagnosis / Q000378:metabolism / Q000628:therapy; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis / Q000378:metabolism / Q000628:therapy; D008297:Male; D008479:Mediastinal Neoplasms / Q000175:diagnosis / Q000378:metabolism / Q000628:therapy; D026901:Membrane Transport Proteins / Q000235:genetics / Q000378:metabolism*; D008875:Middle Aged; D009185:Myelin Proteins / Q000235:genetics / Q000378:metabolism*; D062806:Myelin and Lymphocyte-Associated Proteolipid Proteins; D009367:Neoplasm Staging; D011510:Proteolipids / Q000235:genetics / Q000378:metabolism*; D015996:Survival Rate; D046888:Tissue Array Analysis
chemical_list: D014408:Biomarkers, Tumor; C569026:MAL protein, human; D026901:Membrane Transport Proteins; D009185:Myelin Proteins; D062806:Myelin and Lymphocyte-Associated Proteolipid Proteins; D011510:Proteolipids