title: Cell cycle characteristics and Epstein-Barr virus are differentially associated with aggressive and non-aggressive subsets of Hodgkin lymphoma in pediatric patients.
abstract: We investigated the correlation of tumor characteristics with clinico-biological markers of aggressive disease, evaluated by Ann Arbor stage, risk group, B-symptoms, number of involved anatomic areas, mediastinal mass, nodular sclerosis (NS) grade, and risk, in pediatric Hodgkin lymphoma (HL). Leukopenia and extranodal disease influenced event-free survival (p = 0.032 and p = 0.041). In multivariate analysis, extranodal disease was associated with high number of tumor-infiltrating eosinophils (p = 0.035) and Ki67 < 50% (p = 0.024); B-symptoms with Ki67 > or =75% (p = 0.027) and high LDH levels (p = 0.001); and mediastinal mass with leukopenia (p = 0.048), NS grade II (p = 0.025), and high-risk (p = 0.046). Furthermore, low stages correlated with Ki67 > or =50% (p = 0.005) and Epstein-Barr virus (EBV) (p = 0.065). Low-risk NS was associated with EBV (p = 0.014). Hierarchical cluster analysis identified two clusters, one composed of high-risk patients and cell cycle and apoptosis features, and the other including low-risk patients, EBV, and low-risk NS. Our results show the association of biological markers with disease aggressiveness in pediatric HL.
authors.affiliation: Bone Marrow Transplantation Center (CEMO), Instituto Nacional de Câncer (INCA), Rio de Janeiro, Brazil.
authors.forename: Mário Henrique M
authors.initials: MH
authors.lastname: Barros
authors.forename: Adriana
authors.initials: A
authors.lastname: Scheliga
authors.forename: Elena
authors.initials: E
authors.lastname: De Matteo
authors.forename: Carolina
authors.initials: C
authors.lastname: Minnicelli
authors.forename: Fernando A
authors.initials: FA
authors.lastname: Soares
authors.forename: Ilana R
authors.initials: IR
authors.lastname: Zalcberg
authors.forename: Rocio
authors.initials: R
authors.lastname: Hassan
mesh_terms: D000293:Adolescent; D018797:Cell Cycle Proteins / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D020031:Epstein-Barr Virus Infections / Q000150:complications*; D005260:Female; D004854:Herpesvirus 4, Human / Q000472:pathogenicity*; D006689:Hodgkin Disease / Q000378:metabolism* / Q000473:pathology / Q000821:virology*; D006801:Humans; D007124:Immunoenzyme Techniques; D016130:Immunophenotyping; D008297:Male; D008479:Mediastinal Neoplasms / Q000378:metabolism / Q000473:pathology / Q000821:virology; D011379:Prognosis; D015996:Survival Rate; D046888:Tissue Array Analysis
chemical_list: D018797:Cell Cycle Proteins