Aberrant T-cell antigen (TCA) expression in classical Hodgkin lymphoma is associated with decreased event-free survival (EFS) and overall survival (OS)
Menée sur une cohorte de 272 patients atteints d'un lymphome hodgkinien classique (âge : 10 à 85 ans ; durée médiane de suivi : 113 mois), cette étude montre que l'expression aberrante d'antigènes des cellules T est associée à une diminution de la survie sans événement et de la survie globale
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 cases of cHL expressing any TCA on the HRS cells (TCA-cHL) were identified in two cohorts (NCI, n=38; Basel n=12). The diagnostic pathology data were examined in all cases with additional TRG@ PCR in a subset of cases. The outcome data were compared with a cohort of cHLs negative for TCA (n=272). Primary endpoints examined were event-free survival (EFS) and overall survival (OS). The median age in the TCA-cHL group was 40 yrs (range: 10-85). Seventy percent (23/33) were in low stage (stage I/II) at presentation. In 40 of 50 cases (80%), the biopsy showed nodular sclerosis (NS) histology with grade 2 subtype predominating in 68% cases. Among the TCA, CD4 and CD2 were most commonly expressed, seen in 37/46 (80.4%) and 24/31 (77.4%) 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 (HRadj=3.32[95%CI: 1.61, 6.84]; p=0.001) and EFS (HRadj=2.55[95%CI: 1.45, 4.49]; p=0.001). TCA-cHL often display NS histology, lack a T-cell genotype and are independently associated with significantly shorter OS and EFS compared to TCA-negative cHLs.
Blood , article en libre accès, 2013