title: Aberrant T-cell antigen expression in classical Hodgkin lymphoma is associated with decreased event-free survival and overall survival.
abstract: Hodgkin/Reed-Sternberg (HRS) cells of classical Hodgkin lymphoma (cHL) rarely express T-cell-associated antigens (TCA), but the clinical significance of this finding is uncertain. Fifty cHLs expressing any TCA on the HRS cells (TCA-cHL) were identified in two cohorts (National Cancer Institute, n = 38; Basel, n = 12). Diagnostic pathology data were examined in all cases with additional T-cell receptor γ rearrangements (TRG@) polymerase chain reaction (PCR) in a subset of cases. The outcome data were compared with a cohort of cHLs negative for TCA (n = 272). Primary end points examined were event-free survival (EFS) and overall survival (OS). The median age in the TCA-cHL group was 40 years (range, 10-85 years). Seventy percent presented in low stage (stage I/II) at presentation with nodular sclerosis (NS) histology predominating in 80% of cases. Among the TCA, CD4 and CD2 were most commonly expressed, seen in 80.4% and 77.4% of cases, respectively. TRG@ PCR was negative for clonal rearrangements in 29 of 31 cases. During a median follow up of 113 months, TCA expression predicted shorter OS (adjusted hazard ratio [HRadj] = 3.32 [95% confidence interval (CI): 1.61, 6.84]; P = .001) and EFS (HRadj = 2.55 [95% CI: 1.45, 4.49]; P = .001). TCA-cHL often display NS histology, lack T-cell genotype, and are independently associated with significantly shorter OS and EFS compared with TCA-negative cHLs.
authors.affiliation: Hematopathology Section, Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA. gvenkat@lumc.edu
authors.forename: Girish
authors.initials: G
authors.lastname: Venkataraman
authors.forename: Joo Y
authors.initials: JY
authors.lastname: Song
authors.forename: Alexandar
authors.initials: A
authors.lastname: Tzankov
authors.forename: Stephan
authors.initials: S
authors.lastname: Dirnhofer
authors.forename: Georg
authors.initials: G
authors.lastname: Heinze
authors.forename: Maria
authors.initials: M
authors.lastname: Kohl
authors.forename: Alexandra
authors.initials: A
authors.lastname: Traverse-Glehen
authors.forename: Franziska C
authors.initials: FC
authors.lastname: Eberle
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Hanson
authors.forename: Mark A
authors.initials: MA
authors.lastname: Raffeld
authors.forename: Stefania
authors.initials: S
authors.lastname: Pittaluga
authors.forename: Elaine S
authors.initials: ES
authors.lastname: Jaffe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000235:genetics / Q000378:metabolism*; D016022:Case-Control Studies; D002648:Child; D015331:Cohort Studies; D004273:DNA, Neoplasm / Q000235:genetics; D005260:Female; D005500:Follow-Up Studies; D015321:Gene Rearrangement; D050438:Genes, Immunoglobulin Heavy Chain / Q000235:genetics; D006689:Hodgkin Disease / Q000235:genetics / Q000378:metabolism / Q000401:mortality*; D006801:Humans; D007124:Immunoenzyme Techniques; D017403:In Situ Hybridization; D061346:Laser Capture Microdissection; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000235:genetics / Q000378:metabolism / Q000401:mortality*; D009367:Neoplasm Staging; D016133:Polymerase Chain Reaction; D011379:Prognosis; D011948:Receptors, Antigen, T-Cell / Q000235:genetics / Q000378:metabolism*; D016539:Reed-Sternberg Cells / Q000378:metabolism*; D015996:Survival Rate; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D004273:DNA, Neoplasm; D011948:Receptors, Antigen, T-Cell