title: The prognostic relevance of tumor associated macrophages in advanced stage classical Hodgkin lymphoma.
abstract: Although the treatment of Hodgkin lymphoma (HL) has been improved, distinguishing reliable prognostic biomarkers could better stratify patients for more effective treatment. We analyzed the prognostic relevance of CD68+ tumor-associated macrophages (TAMs) by immunohistochemical analysis at diagnosis and standard clinical parameters in 52 ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine)-treated patients with advanced stage classical HL (cHL). Patients with >25% CD68+ TAMs compared to those with ≤25% had worse 5-year overall survival (45% vs. 77%, log-rank p = 0.019) and showed a trend toward shorter 5-year event-free survival (51% vs. 71%, log-rank p = 0.19). Additionally, no significant correlation with selected clinical features was found. Significantly shorter 5-year overall survival was associated with International Prognostic Score (IPS) >2, bulky disease, elevated erythrocyte sedimentation rate (log-rank test, p = 0.003, p = 0.049, p = 0.007, respectively). In multivariate analysis, increased CD68+TAMs, IPS >2, and bulky disease were identified as independent prognostic factors for overall survival (Cox multivariate model, p = 0.006, p = 0.007, p = 0.013, respectively). Tumor-associated macrophages represent a potential prognostic biomarker which could contribute to better risk stratification of patients with cHL.
authors.affiliation: Clinic for Hematology, Clinical Center of Serbia, Belgrade, Serbia. ljubajak@yahoo.com
authors.forename: Ljubomir R
authors.initials: LR
authors.lastname: Jakovic
authors.forename: Biljana S
authors.initials: BS
authors.lastname: Mihaljevic
authors.forename: Maja D
authors.initials: MD
authors.lastname: Perunicic Jovanovic
authors.forename: Andrija D
authors.initials: AD
authors.lastname: Bogdanovic
authors.forename: Bosko M
authors.initials: BM
authors.lastname: Andjelic
authors.forename: Vladimir Z
authors.initials: VZ
authors.lastname: Bumbasirevic
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000032:analysis*; D015214:Antigens, Differentiation, Myelomonocytic / Q000032:analysis*; D014408:Biomarkers, Tumor / Q000032:analysis; D005260:Female; D006689:Hodgkin Disease / Q000276:immunology / Q000401:mortality / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D008264:Macrophages / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D055815:Young Adult; D000097382:CD68 Molecule
chemical_list: D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D014408:Biomarkers, Tumor; C067980:CD68 antigen, human; D000097382:CD68 Molecule