Originally published as JCO Early Release 10.1200/JCO.2006.06.5342 on September 5 2006

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Prognostic Significance of T-Cell or Cytotoxic Molecules Phenotype in Classical Hodgkin’s Lymphoma: A Clinicopathologic Study

Naoko Asano, Aya Oshiro, Keitaro Matsuo, Yoshitoyo Kagami, Fumihiro Ishida, Ritsuro Suzuki, Tomohiro Kinoshita, Yoshie Shimoyama, Jun-Ichi Tamaru, Tadashi Yoshino, Kunio Kitamura, Hisashi Fukutani, Yasuo Morishima, Shigeo Nakamura

From the Department of Pathology and Molecular Diagnostics, Division of Epidemiology and Prevention, and Department of Hematology and Chemotherapy, Aichi Cancer Center; Department of HSCT Data Management, Department of Hematology, and Department of Pathology and Clinical Laboratories, Nagoya University, Nagoya; Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto; Department of Pathology, Saitama Medical Center, Saitama Medical School, Kawagoe; Department of Pathology, Faculty of Health Sciences, Okayama University, Okayama; Department of Internal Medicine, Ichinomiya Municipal Hospital, Ichinomiya; and Department of Internal Medicine, Aichi Hospital, Aichi Cancer Center, Okazaki, Japan

Address reprint requests to Naoko Asano, MD, Department of Pathology and Molecular Diagnostics, Aichi Cancer Center, 1-1 Kanokoden, Chikusa-ku, Nagoya 464-8681, Japan; e-mail: nasano{at}aichi-cc.jp

PURPOSE: Classical Hodgkin’s lymphoma (CHL) is characterized by Hodgkin’s and Reed-Sternberg (H-RS) cells, most of which are derived from germinal-center B cells. Nevertheless, one or more markers for T cells and follicular dendritic cells (FDC) may be expressed in a minority of H-RS cells in some CHL patients, although the clinical significance of this remains controversial. The aim of this study was to clarify the association between phenotypic expression and clinical outcome in CHL.

PATIENTS AND METHODS: Participants were 324 consecutive CHL patients, comprising 132 patients with nodular sclerosis (NS), 35 patients with NS grade 2 (NS2), and 157 patients with mixed cellularity (MC). We evaluated the presenting features and prognosis of patients on categorization into four phenotypically defined groups: B-cell (CD20⁺ and/or CD79a⁺; n = 63), T-cell and/or cytotoxic molecules (CD3⁺, CD4⁺, CD8⁺, CD45RO⁺, TIA-1⁺, and/or granzyme B⁺; n = 27), FDC (CD21⁺ without B-cell marker; n = 22), and null-cell types (n = 212). Other potential prognostic factors were examined.

RESULTS: The T-cell and/or cytotoxic molecules group showed a significantly poorer prognosis than the other three groups (P < .0001). This finding was seen consistently in multivariate analyses. Morphologic subtyping (NS/NS2/MC) and Epstein-Barr virus positivity were not identified as independent prognostic factors.

CONCLUSION: The presence of T-cell and/or cytotoxic antigens in H-RS cells may represent a poor prognostic factor in CHL, even if their expression is not regarded as lineage specific. Examination of T-cell and/or cytotoxic molecules phenotype in CHL patients is recommended as a routine pathologic practice.

published online ahead of print at www.jco.org on September 5, 2006.

Authors’ disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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