title: Evaluation of the prognostic role of tumour-associated macrophages in newly diagnosed classical Hodgkin lymphoma and correlation with early FDG-PET assessment.
abstract: In Hodgkin Lymphoma (HL), about 20% of patients still have relapsed/refractory disease and late toxic effects rate continue to rise with time. 'Early FDG-PET' and tissue macrophage infiltration (TAM) emerged as powerful prognostic predictors. The primary endpoint was to investigate the prognostic role of both early FDG-PET and TAM; the secondary endpoint was to test if early FDG-PET positivity could correlate with high TAM score. A cohort of 200 HL patients was analysed. Induction treatment plan consisted of two to six courses of ABVD and, if indicated, involved field radiation therapy. All patients repeated CT scan and FDG-PET after two cycles and after the completion of therapy. TAM in diagnostic specimens was determined by immunohistochemistry with a monoclonal antibody (anti-CD68 KP1). Overall, early FDG-PET was negative in 163 patients (81.5%) and positive in 37 patients (18.5%), showing a significant correlation with the achievement of CR (p < 0.0001). After a median follow-up of 40 months, progression free survival (PFS) was significantly better for PET negative patients (p < 0.0001). CD68 expression was low, intermediate or high in 26 (13%), 100 (50%) and 74 (37%) cases, without difference in the distribution between responders and non-responders. PFS analysis showed no significant difference in any score group. TAM score did not show any correlation with early FDG-PET result. This study confirms that early FDG-PET has a high prognostic power, while TAM score does not seem to influence the outcome; in contrast to our original hypothesis, it does not correlate with FDG-PET assessment. Copyright © 2015 John Wiley & Sons, Ltd.
authors.affiliation: Unit of Hematology, Azienda Ospedaliera Universitaria Senese, Italy.|University of Siena, Siena, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Cencini
authors.affiliation: Unit of Hematology, Azienda Ospedaliera Universitaria Senese, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Fabbri
authors.affiliation: Hematology Department, University of Florence, Florence, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Rigacci
authors.affiliation: Department of Human Pathology and Oncology, University of Siena, Siena, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Lazzi
authors.affiliation: Hematology Department, Azienda Ospedaliera Universitaria 'Ospedali Riuniti', Ancona, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Gini
authors.affiliation: Hematology Department, Ospedale S.Andrea, Roma, Italy.
authors.forename: Maria Christina
authors.initials: MC
authors.lastname: Cox
authors.affiliation: Hematology Division, Azienda Universitaria Policlinico, Palermo, Italy.
authors.forename: Salvatrice
authors.initials: S
authors.lastname: Mancuso
authors.affiliation: Hematology Department, Ospedale S.Eugenio, Roma, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Abruzzese
authors.affiliation: Hematology Department, University of Florence, Florence, Italy.
authors.forename: Sofia
authors.initials: S
authors.lastname: Kovalchuk
authors.affiliation: Pathology Department, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: Gaia
authors.initials: G
authors.lastname: Goteri
authors.affiliation: Pathology Unit, Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, La Sapienza University, Rome, Italy.
authors.forename: Arianna
authors.initials: A
authors.lastname: Di Napoli
authors.affiliation: Hematology Division, Azienda Universitaria Policlinico, Palermo, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Bono
authors.affiliation: Pathology Department, Ospedale S.Eugenio, Rome, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Fratoni
authors.affiliation: Pathology Department, University of Florence, Florence, Italy.
authors.forename: Simonetta
authors.initials: S
authors.lastname: Di Lollo
authors.affiliation: Hematology Department, University of Florence, Florence, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Bosi
authors.affiliation: Department of Human Pathology and Oncology, University of Siena, Siena, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Leoncini
authors.affiliation: Unit of Hematology, Azienda Ospedaliera Universitaria Senese, Italy.|University of Siena, Siena, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Bocchia
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000737:chemistry; D015703:Antigens, CD / Q000737:chemistry; D015214:Antigens, Differentiation, Myelomonocytic / Q000737:chemistry; D000971:Antineoplastic Combined Chemotherapy Protocols; D001761:Bleomycin; D015331:Cohort Studies; D003606:Dacarbazine; D018572:Disease-Free Survival; D004317:Doxorubicin; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006689:Hodgkin Disease / Q000097:blood* / Q000175:diagnosis / Q000000981:diagnostic imaging*; D006801:Humans; D007150:Immunohistochemistry; D008264:Macrophages / Q000166:cytology*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D000072078:Positron Emission Tomography Computed Tomography; D049268:Positron-Emission Tomography; D011379:Prognosis; D012008:Recurrence; D016896:Treatment Outcome; D014747:Vinblastine; D055815:Young Adult; D000097382:CD68 Molecule
chemical_list: D000911:Antibodies, Monoclonal; D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D001761:Bleomycin; D003606:Dacarbazine; D004317:Doxorubicin; D019788:Fluorodeoxyglucose F18; D014747:Vinblastine; C067980:CD68 antigen, human; D000097382:CD68 Molecule
keywords: CD68; Hodgkin's lymphoma; PET; macrophages; prognosis