CD20-позитивные B-лимфоциты в реактивном микроокружении опухоли как независимый иммуногистохимический фактор прогноза при нодулярном склерозе классической лимфомы Ходжкина

Abstract

Aim. To assess the prognostic value of CD20-positive B-lymphocytes in the reactive tumor microenvironment using histological specimens of lymph nodes from patients with nodular sclerosis classical Hodgkin lymphoma (cHL). Materials & Methods. The analysis focused on archival samples (paraffin blocks and cassettes) of lymph nodes from 71 patients with newly diagnosed cHL, nodular sclerosis type. Immunohistochemical methods were used for morphometric assessment of CD20-positive cells in the tumor microenvironment. In each lymph node biopsy sample, 20 fields of view were analyzed for the mean relative count of CD20-positive B-lymphocytes in the reactive tumor microenvironment. The В-cell count was determined by the double-blind method. Patients were aged 18–77 years (median 35 years); there were 37 women and 34 men. According to the primary documentation, 11 (15.5 %) patients received ABVD as first-line therapy and 60 (84.5 %) patients were treated with BEACOPP-14 (EACOPP-14) or BEACOPPesc regimens. Results. A low count of CD20-positive B-lymphocytes in the reactive tumor microenvironment is regarded as an independent factor of poor prognosis in patients with nodular sclerosis cHL. This is the category of patients who show worse event-free survival (EFS) rates. In the cohort with the subthreshold count of CD20-positive B-lymphocytes in the reactive microenvironment, the median EFS was 38 months, whereas in the cohort with the above-threshold count it was not reached. Conclusion. The results of this study demonstrate the need to assess the relative count of CD20-positive B-lymphocytes in the reactive tumor microenvironment in patients with nodular sclerosis cHL at the primary diagnosis stage. There is every reason to believe that for this category of patients the incorporation of this immunohistochemical parameter into the existing predictive models is fully justified.