title: Peripheral blood CD4/CD19 cell ratio is an independent prognostic factor in classical Hodgkin lymphoma.
abstract: Classical Hodgkin lymphoma (cHL) is characterized by the presence of tumoral cells in a rich background of T and B cells, macrophages and other inflammatory cells. The contribution of these non-tumoral cells to the pathogenesis of HL is still poorly understood. In our study we evaluated the prognostic significance of peripheral blood B, T and natural killer (NK) cells at diagnosis in 118 immunocompetent patients with cHL treated at our institution between January 2006 and December 2010. Fifty-four (46%) were male and 64 (54%) female. Median age at diagnosis was 33 years (range 15-82), and 71 patients (60%) presented an advanced stage (IIB-IV), 54 (46%) had bulky disease and 55 (47%) presented B symptoms. At the end of treatment, 94 patients (80%) had a complete response (CR) and 24 (20%) had a partial response. After a median follow-up of 54 months, 18 patients (15%) had relapsed. The variables that had a negative impact on progression-free survival (PFS) at univariate analysis were advanced stage, bone marrow involvement, International Prognostic Score (IPS) ≥ 3, positive interim positron emission tomography (int-PET), NK cells < 200/μL, CD19 cells < 85/μL, CD3/CD19 ratio ≥ 13 and CD4/CD19 ratio ≥ 10. At multivariate analysis, advanced stage, positive int-PET and CD4/CD19 ratio ≥ 10 were independent prognostic factors of PFS. New biological markers could be predictive of the response to treatment and survival in cHL. A CD4/CD19 ratio ≥ 10 seems to be associated with a worse outcome.
authors.affiliation: Hematology Section, Department of Emergency and Organ Transplantation, University of Bari Medical School , Bari , Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Gaudio
authors.forename: Tommasina
authors.initials: T
authors.lastname: Perrone
authors.forename: Anna
authors.initials: A
authors.lastname: Mestice
authors.forename: Paola
authors.initials: P
authors.lastname: Curci
authors.forename: Annamaria
authors.initials: A
authors.lastname: Giordano
authors.forename: Mario
authors.initials: M
authors.lastname: Delia
authors.forename: Domenico
authors.initials: D
authors.lastname: Pastore
authors.forename: Giorgina
authors.initials: G
authors.lastname: Specchia
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015703:Antigens, CD / Q000378:metabolism; D018941:Antigens, CD19 / Q000378:metabolism; D015704:CD4 Antigens / Q000378:metabolism; D005260:Female; D006689:Hodgkin Disease / Q000175:diagnosis* / Q000276:immunology* / Q000401:mortality / Q000628:therapy; D006801:Humans; D016130:Immunophenotyping; D018655:Lymphocyte Count; D016131:Lymphocyte Subsets / Q000276:immunology* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D049268:Positron-Emission Tomography; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015703:Antigens, CD; D018941:Antigens, CD19; D015704:CD4 Antigens
keywords: Hodgkin lymphoma; Lymphocytes; prognosis