title: Expression of COX-2 on Reed-Sternberg cells is an independent unfavorable prognostic factor in Hodgkin lymphoma treated with ABVD.
abstract: Cyclooxygenase 2 (COX-2) is an inflammatory enzyme involved in the pathogenesis and prognosis of several malignancies. In the present study, we investigated the prognostic value of COX-2 expression in a large (N = 242), uniformly treated Hodgkin lymphoma (HL) population from the Spanish Network of HL using tissue microarrays. Univariate and multivariate analysis was done, including comparing the most recognized clinical variables: the early- and advanced-stage subgroups. COX-2 was expressed on Reed-Sternberg cells in 37% of patients. There were no differences in the distribution of clinical variables according to COX-2 expression. With a median follow-up time of 58 months, PFS at 5 years was 60% and 79% for COX-2(+) and COX-2(-) patients, respectively (P = .003). The overall survival was 73% and 91%, respectively (P < .001). The major impact on prognosis was observed in the early AA stage (I-II) group. In fact, in these low-risk groups the expression of COX-2 defined a group with significantly worse progression-free and overall survival. In conclusion, COX-2 was expressed on Reed-Sternberg cells in one-third of HL patients and was a major independent, unfavorable prognostic factor in early-stage HL. We conclude that COX-2 may be a major prognostic variable in HL and a potential therapeutic target.
authors.affiliation: Department of Radiotherapy, University Hospital Son Espases, Palma de Mallorca, Balearic Islands, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Mestre
authors.forename: Antonio
authors.initials: A
authors.lastname: Gutierrez
authors.forename: Rafael
authors.initials: R
authors.lastname: Ramos
authors.forename: Jordi
authors.initials: J
authors.lastname: Martinez-Serra
authors.forename: Lydia
authors.initials: L
authors.lastname: Sánchez
authors.forename: Gabriel
authors.initials: G
authors.lastname: Matheu
authors.forename: Teresa
authors.initials: T
authors.lastname: Ros
authors.forename: Juan Fernando
authors.initials: JF
authors.lastname: Garcia
authors.forename: Jose
authors.initials: J
authors.lastname: Rodriguez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000378:metabolism; D001761:Bleomycin / Q000627:therapeutic use; D002648:Child; D051546:Cyclooxygenase 2 / Q000378:metabolism*; D003606:Dacarbazine / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D006689:Hodgkin Disease / Q000175:diagnosis* / Q000188:drug therapy* / Q000378:metabolism / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D016539:Reed-Sternberg Cells / Q000378:metabolism* / Q000473:pathology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014747:Vinblastine / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D001761:Bleomycin; D014747:Vinblastine; D003606:Dacarbazine; D004317:Doxorubicin; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human