scholarly journals Problema Diagnostik dan Respons Kemoterapi pada Seorang Penderita Classical Limfoma Hodgkin Tipe Mixed Cellularity dengan Temporary Spontaneus Regression

2019 ◽  
Vol 3 (1) ◽  
pp. 7
Author(s):  
Daniel Maranatha ◽  
Bintang Bestari
Keyword(s):  
Ct Scan ◽  
Hodgkin Lymphoma ◽  
Chemotherapy Response ◽  
Classical Hodgkin Lymphoma ◽  
First Line ◽  
Mixed Cellularity ◽  
Supraclavicular Lymph Nodes ◽  
Chest X Ray ◽  
Thoracic Ct Scan ◽  
Line Chemotherapy

Background: Mixed cellularity classical hodgkin lymphoma (MCCHL) is the secound subtype of classical hodgkin lymphoma (cHL) which often happens. MCCHL is aggressive but has a relatively high recovery rate. The diagnosis of cHL is sometimes difficult. Spontaneous regression can occur in cHL but is very rare, temporary or permanent. CHL including diseases with a fairly high cure rate, about 80% of patients recover with first-line chemotherapy. Case: Male age 26 years, 9 months cough, shortness of breath, chest pain 8 months, 6 months fever disappear with enlargement of right supraclavicular lymph nodes appearing at 11 days before admission. Chest X-ray shows the presence of mediastinal mass supported by contrast thoracic CT scan. FNAB has been done three times with no meaningful results. In one of the chest radiographs and CT scan of the thoracic with contrast evaluation showed a reduction in tumor size. Open thoracotomy biopsy is performed with Hodgkin’s lymphoma results. On immunohistochemical examination obtained MCCHL. Chemotherapy with ABVD regimen was administered for three cycles with partial remission and was continued with 6 cycles with stable disease outcomes. Conclusion: Spontaneous temporary regression in cases with mediastinal tumor suspicion may occur in cHL and may cause difficulties in diagnosing. Open biopsy is required as a gold standard and has to be supported by immunohistochemical test. First-line chemotherapy response in cHL is good.Background: Mixed cellularity classical hodgkin lymphoma (MCCHL) is the secound subtype of classical hodgkin lymphoma (cHL) which often happens. MCCHL is aggressive but has a relatively high recovery rate. The diagnosis of cHL is sometimes difficult. Spontaneous regression can occur in cHL but is very rare, temporary or permanent. CHL including diseases with a fairly high cure rate, about 80% of patients recover with first-line chemotherapy. Case: Male age 26 years, 9 months cough, shortness of breath, chest pain 8 months, 6 months fever disappear with enlargement of right supraclavicular lymph nodes appearing at 11 days before admission. Chest X-ray shows the presence of mediastinal mass supported by contrast thoracic CT scan. FNAB has been done three times with no meaningful results. In one of the chest radiographs and CT scan of the thoracic with contrast evaluation showed a reduction in tumor size. Open thoracotomy biopsy is performed with Hodgkin’s lymphoma results. On immunohistochemical examination obtained MCCHL. Chemotherapy with ABVD regimen was administered for three cycles with partial remission and was continued with 6 cycles with stable disease outcomes. Conclusion: Spontaneous temporary regression in cases with mediastinal tumor suspicion may occur in cHL and may cause difficulties in diagnosing. Open biopsy is required as a gold standard and has to be supported by immunohistochemical test. First-line chemotherapy response in cHL is good.

Phase II trial of ofatumumab plus ESHAP (O-ESHAP) as salvage treatment for patients with relapsed or refractory classical Hodgkin lymphoma after first-line chemotherapy

2016 ◽  
Vol 174 (6) ◽  
pp. 859-867 ◽  
Author(s):  
Carmen Martínez ◽  
Antonio Díaz-López ◽  
Mercedes Rodriguez-Calvillo ◽  
Ramón García-Sanz ◽  
María José Terol ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Phase Ii ◽  
Phase Ii Trial ◽  
Salvage Treatment ◽  
Classical Hodgkin Lymphoma ◽  
First Line ◽  
Line Chemotherapy

scholarly journals First-Line Chemotherapy Response Is a Predictive Factor for Immune Checkpoint Inhibitors Treatment in Advanced Urothelial Carcinoma, a Real World Retrospective Study

2021 ◽  
Author(s):  
Jian-Ri Li ◽  
Shian-Shiang Wang ◽  
Kevin Lu ◽  
Chuan-Shu Chen ◽  
Chen-Li Cheng ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Urothelial Carcinoma ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
The Other ◽  
Chemotherapy Response ◽  
First Line ◽  
Advanced Urothelial Carcinoma ◽  
Line Chemotherapy

Abstract Background: Immune checkpoint inhibitors (ICIs) have become important tools for the treatment of advanced urothelial carcinoma (aUC). However, the clinical strategy using ICIs and chemotherapy is still controversy. The aim of this study was to evaluate the association of clinical parameters in aUC patients with ICIs treatment.Methods: We retrospectively analyzed aUC patients who received atezolizumab and pembrolizumab between January 2015 and October 2020. The associations between baseline demographics and clinical outcomes were evaluated.Results: Of the 74 included patients, the median age was 67 years. Among them, 53 patients received atezolizumab and the other 21 received pembrolizumab. There were 50 patients receiving first line ICIs therapy and the other 24 received second line monotherapy. Fifty-two (83.87%, 52/62) received cisplatin among all chemotherapy patients. The median progression free survival was 10.94 months and the overall survival was 28.44 months. Poor chemotherapy response or no chemotherapy, liver metastases, Eastern Cooperative Oncology Group (ECOG) status and higher neutrophil/lymphocyte ratio (NLR) were associated with higher risk of diseases progression (HR=5.70, 95% CI 2.04-15.90, p=0.001, HR=6.08, 95% CI 1.79-20.57, p=0.004; HR=5.40, 95% CI 1.76-16.57, p=0.003; HR=6.08, 95% CI 2.56-14.44, p<0.001 and HR= 1.02, 95% CI 1.01-1.03, P=0.002 respectively). Liver metastases and WBC before ICI were associated with increased death risk (HR=11.95, 95%CI 3.22-44.34, p<0.001; HR=1.0001, 95% CI 1.00001-1.00002, p=0.036 respectively) while ICI response was associated with decreased death (HR=0.22, 95%CI 0.08-0.62, p=0.004). Chemotherapy responders were associated with better ICI treatment response (OR=6.52, 95%CI 1.45-29.24, p=0.014) while lymph node metastases and poor ECOG was associated with poor ICI response (OR=0.31, 95%CI 0.10-0.94, p=0.038; OR=0.32, 95%CI 0.11-0.95, p=0.040).Conclusions: Our data showed predictive role of first-line chemotherapy response to ICIs treatment efficacy in aUC patients as well as other prognostic factors, such as ECOG status, serum white blood cell count or NLR and liver metastases.

Prognostic Significance of Immunohistochemical Markers in Classical Hodgkin Lymphoma Response to Treatment A Study of 59 Cases.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 972-972 ◽  
Author(s):  
Danielle Canioni ◽  
Benedicte Deau ◽  
Pierre Taupin ◽  
Jacques Bosq ◽  
Vincent Ribrag ◽  
...  
Keyword(s):  
Treatment Response ◽  
Hodgkin Lymphoma ◽  
Prognostic Significance ◽  
Response To Treatment ◽  
Rank Test ◽  
Classical Hodgkin Lymphoma ◽  
High Power Field ◽  
Mixed Cellularity ◽  
P53 Expression ◽  
Immunohistochemical Markers

Abstract Classical Hodgkin lymphoma (cHL) belongs to the most curable lymphomas in adults. Some cHL however, are primary refractory to usual treatments including anthracyclins regimen. Currently, only clinical factors are considered as relevant for prognosis. In a previous study of a small cohort of patients, we showed that some immunohistochemical markers could help for predicting the treatment response of cHL. In this study, we extended the markers and increased the number of included patients. We performed a retrospective study on pre-treatment biopsy specimen of 59 patients, 18 with primary refractory cHL and 41 responders to chemotherapy and free of disease for at least 3 years. Most refractory cHL had a nodular sclerosis (NS) histological type, except one which was a mixed cellularity type. Thirty six responders had a NS type, 3 patients had a mixed cellularity type and the 2 others an interfollicular cHL. The semi-quantitative immunohistochemical study used CD20, CD3, CD30, bcl2, p53, Ki67, TiA1 and c-kit antibodies. The results were statistically evaluated using a Fisher ’s exact test or a Wilcoxon sum rank test depending on the variable studied. CD30 and Ki67 stained strongly Hodgkin (Hg) and Reed-Sternberg (RS) cells regarless the response status. In contrast, these cells expressed significantly less frequently CD20 in refractory cHL than in responders (p= 0.032) and were never stained with CD3. P53 and bcl2 had a significantly higher expression on Hg or RS cells in refractory cHL (median = 63% & 51%) compared to responders (median = 40% & 12%) (p=0.004 & p=0.015 respectively). The cytotoxic marker TiA1 stained significant higher number of small lymphocytes in refractory cHL (median=42.5 per high power field (hpf)) compared to responders (median= 21 per hpf) (p= 0.0006). C-kit antibody was negative in Hg or RS cells but stained significant more mastocytes in refractory cHL (median=9 per hpf) comparing to responders (median=3.8 per hpf) (p= 0.001). These results indicate that immunohistochemical markers are useful in cHL and should be used in association with clinical parameters for predict the cHL treatment response. The prognostic significance of CD20 expression in cHL is controversial but in this study seems predictive of a better treatment response and is merely a marker of different gene expression program that may be associated with a more favorable outcome. A high bcl2 and p53 expression in refractory cHL supports the notion that an intact apoptosis cascade is essential for cell killing effect of chemotherapy. The increasing of TiA1 and c-kit positive cells raises the importance of the environmental non-neoplastic cells in cHL and suggests that targeted therapy against mast cells could improve prognosis of refractory cHL.

Clinicopathological Features of Nodular Sclerosis-Type Classical Hodgkin Lymphoma In the Elderly: Multicenter Study of Hodgkin Lymphoma In Japan

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 2677-2677
Author(s):  
Naoko Asano ◽  
Tomohiro Kinoshita ◽  
Koichi Ohshima ◽  
Tadashi Yoshino ◽  
Nozomi Niitsu ◽  
...  
Keyword(s):  
Board Of Directors ◽  
Hodgkin Lymphoma ◽  
Research Funding ◽  
The Elderly ◽  
Clinicopathological Features ◽  
Line Treatment ◽  
Classical Hodgkin Lymphoma ◽  
First Line ◽  
Advisory Committees ◽  
First Line Treatment

Abstract Abstract 2677 Background: Classical Hodgkin lymphoma (CHL), which is characterized by the presence of Hodgkin and Reed Sternberg (H-RS) cells in a background of non-neoplastic inflammatory cells, is divided into four histological subgroups, nodular sclerosis (NSCHL), mixed cellularity (MCCHL), lymphocyte-rich, and lymphocyte depletion. While NSCHL in young adults is characterized by a mediastinal mass and good prognosis, the clinicopathological characteristics of NSCHL in the elderly (NSCHL-e) remain uncertain. Patients and methods: Enrolled patients were diagnosed with CHL between 1986 and 2006 as part of the Hodgkin Lymphoma's Multicenter Study Group. To better characterize NSCHL-e, we compared the clinicopathological profiles of 84 NSCHL-e patients aged 50 or over with 237 NSCHL-y patients aged 49 or younger and 302 with MCCHL. Results: The total of 743 CHL patients consisted of 496 men and 247 women with a median age of 48 years (range, 15– 89 years). The pathological diagnoses were NSCHL in 324 patients (43%) and MCCHL in 303 (41%). NSCHL patients showed a bimodal age distribution, with an initial peak in their 20s and a second small peak in their 60s. We categorized the former as NSCHL-y (49 or younger) and the latter as NSCHL-e (50 and over). NSCHL-e patients were characterized by male predominance and a more advanced clinical stage (53%) than NSCHL-y. Immunophenotypically, H-RS cells had the prototypic immunophenotype of CD15+ CD30+ and Pax5+. NSCHL-e cases showed a significantly higher rate of CD20 (24%) than NSCHL-y (8%, P = 0.001). Furthermore, H-RS cells in 29 of 75 (39%) patients with NSCHL-e were positive for EBV RNA transcripts by in situ hybridization, whereas only 7% of NSCHL-y cases were EBER-positive (P < 0.0001) (Table). Regarding NSCHL-e and MCCHL, no significant difference between these patients was seen in clinical characteristics. Immunophenotypically, NSCHL-e patients showed significantly higher rates for CD3 and TIA-1, while MCCHL patients showed higher EBV positivity (75%). Fifty-five of 63 patients received systemic multi-agent chemotherapy as first-line treatment, consisting of doxorubicin, bleomycin, vinblastine, and dacarbacin (ABVD) in 38 patients; CHOP in 8; C-MOPP in 8; and BEACOPP in 1. Overall, 51 patients responded to first-line treatment, 39 with complete response and 12 with partial response. Disease-specific survival of NSCHL-e was poorer than that of NSCHL-y (P < 0.001) but similar to that of MCCHL (P = 0.43) (Figure). Conclusion: NSCHL-e is characterized by an unfavorable prognosis and different clinicopathological features to NSCHL-y, which is considered as typical NSCHL. A number of cases of NSCHL-e might have been associated with MCCHL, with most being EBV-positive. These results suggest the limitations of current histological subgroupings for CHL. Disclosures: Matsushita: Pfizer CO.: Membership on an entity's Board of Directors or advisory committees, Research Funding; Baxter Co.: Membership on an entity's Board of Directors or advisory committees, Research Funding.

Guidelines for the first line management of classical Hodgkin lymphoma

2014 ◽  
Vol 166 (1) ◽  
pp. 34-49 ◽  
Author(s):  
George A. Follows ◽  
Kirit M. Ardeshna ◽  
Sally F. Barrington ◽  
Dominic J. Culligan ◽  
Peter J. Hoskin ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Classical Hodgkin Lymphoma ◽  
First Line ◽  
Line Management

Is antimicrobial prophylaxis necessary for lymphoma patients? A single centre, real-life experience

2018 ◽  
Vol 25 (6) ◽  
pp. 1381-1387 ◽  
Author(s):  
Abdulkerim Yıldız ◽  
Hacer BA Öztürk ◽  
Murat Albayrak ◽  
Çiğdem Pala ◽  
Osman Şahin ◽  
...  
Keyword(s):  
Febrile Neutropenia ◽  
Hodgkin Lymphoma ◽  
Antimicrobial Prophylaxis ◽  
Real Life ◽  
First Line ◽  
Documented Infection ◽  
Total Incidence ◽  
Significant Difference ◽  
Line Chemotherapy

Background Prophylaxis is strongly recommended in patients with hematological malignancy who are usually at higher risk for infection and neutropenic fever. It is still unclear whether or not there is a definite need for antimicrobial prophylaxis in intermediate-risk hematology patients such as those with lymphoma. Methods A retrospective analysis was made of patients admitted from January 2009 to December 2017 to the Hematology Department of Diskapi Yildirim Beyazit Training and Research Hospital, a tertiary referral hospital in Ankara, Turkey. The study included patients who were diagnosed with any type of lymphoma and given chemotherapy. Routine antimicrobial prophylaxis was administered to 127 lymphoma patients, and not to 65 lymphoma patients. These two groups were compared in respect of the incidence of total infection episodes (IE), febrile neutropenia episodes, and nonneutropenic clinically documented infection episodes. Results For all patients with lymphoma and subtypes of non-Hodgkin lymphoma or Hodgkin lymphoma, no significant difference was determined between the groups in respect of the total incidence of IE, febrile neutropenia and nonneutropenic clinically documented infection both during the first-line chemotherapy and throughout the total follow-up period ( p > 0.05). Patients with prophylaxis had a higher incidence of IE, which was treated with parenteral antibiotics both during the first-line chemotherapy and throughout the total follow-up period ( p < 0.05). Conclusion Antimicrobial prophylaxis was seen to have no effect on the total incidence of infection episode and febrile neutropenia. Therefore, the routine use of antimicrobial prophylaxis should not be recommended for patients with lymphoma.

scholarly journals PVAG Regimen (Prednisone, Vinblastine, Doxorubicin, Gemcitabine) Used in Real-Life Setting in First Line Therapy for Elderly Classical Hodgkin Lymphoma Patients: A Retrospective Study of Lysa Centers

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 11-11
Author(s):  
Guillaume Aussedat ◽  
Maryam Idlhaj ◽  
Amandine Durand ◽  
Xavier Roussel ◽  
Pauline Brice ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Overall Survival ◽  
Hodgkin Lymphoma ◽  
Real Life ◽  
Hematologic Toxicity ◽  
Classical Hodgkin Lymphoma ◽  
First Line ◽  
Real Life Setting ◽  
Grade 3 ◽  
Advisory Role

Introduction: Older patients with an age above 60 years with classical Hodgkin lymphoma (cHL) represent a proportion of 20% to 30% of all cHL. Older cHL patients are characterized by unfavorable prognostic factors with an aggressive disease, a poor tolerance to chemotherapy especially with bleomycin-induced lung toxicity resulting to a significant reduced survival as compared to younger patients. PVAG regimen (prednisone, vinblastine, doxorubicin, gemcitabine) was developed by the German Hodgkin Study Group (GHSG) to improve results and reduce toxicities of ABVD regimen. In a prospective phase II study of 55 early unfavorable and advanced-stage elderly HL patients (median age, 68 years), 78% achieved complete response (CR) with a 3-year progression free survival (PFS) and overall survival (OS) rates of 58% and 66%, respectively (Böll et al, Blood 2011) with favorable toxicity profile. To the best of our knowledge, there is no report that described efficacy and toxicity of this protocol in real-life setting. Methods: Between June 2011 and February 2020, 49 elderly patients with cHL received first-line chemotherapy with PVAG (Prednisone 40 mg/m2, Vinblastine 6 mg/m2, Doxorubicin 50 mg/m2, Gemcitabine 1000 mg/m2, or adapted-dose of PVAG) in 6 LYSA centers. All medical records were reviewed for clinical and biological characteristics, modality of treatment, responses and outcome. Comorbidities were evaluated according to the cumulative illness rating scale for geriatrics (CIRS-G) and treatment-related toxicity according to the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE). Results: The median age of the 49 patients was 76 years (range, 61-87) with 44 patients ≥70 years old (69%) and 27 male (55%). Ann Arbor stages were as follows: II (n=16, 33%), III (n=12, 24%), IV (n=21, 43%). Altered performance status (PS 2-4) was presented in 35% of patients and B symptoms in 59%. IPS was ≥3 in 32 (65%) patients. CIRS-G Grade 3 or 4 in two or more categories was observed in 11 patients (22%) and 22 patients (43%) had a cumulative CIRS-G score over 6. Patients received a median of 6 cycles (range 1-8), 21 of them (43%) received adapted dose of PVAG. Seven patients (14%) received radiotherapy after respectively 3, 4, 6, or 8 cycles of PVAG. At the end of PVAG regimen, 26 patients were in CR (53%), 4 PR (8%), 19 patients progressed (39%). For the 46 patients who were evaluated by PET-CT after chemotherapy, the CR and PR rates were 52% and 13% with 35% of patients with stable or progressive diseases. For hematologic toxicity, 6 patients (12%) developed febrile neutropenia, 22 (45 %) had grade III-IV neutropenia; 8 (16 %) a grade 3-4 thrombopenia; 17 (35%) grade 3-4 anemia. Extra-hematologic toxicities were mild with three patients (6%) with grade 3-4 mucositis, 2 (4%) grade 3-4 nausea, 5 (10%) with grade 3-4 neuropathy, 3 (6%) acute heart toxicity. With a median follow up of 33,2 months (range, 14,3 -53,7), 26 (53%) patients progressed or relapsed. The median PFS was 21,6 months with a 3-year PFS rate of 48,6% (95%CI, 36,3-65,1). The median overall survival (OS) was 66,5 months with a 3-year OS rate of 73,7% (95%CI, 61,2-88,8). The cause of death was HL in 8 patients (16%), infection in 2 (4%); one toxic death occurred (sepsis after first cycle of PVAG). In univariate analysis, PFS (HR: 2,36, 95CI, 1,01-5,48, P=0.0,046) and OS (HR: 4,23, 95%CI, 1,15-15,6, P=0.03) were adversely affected by high number of medications (&gt;3). OS was adversely affected by grade 3-4 CIRS-G in ≥2 categories (HR: 3,63, 95%CI, 1,23-10,71, P=0.019). Age, IPS, presence of B symptoms, lymphopenia, anemia, low albumin level, CIRS-G&gt;6 did not affect outcome. Conclusions:Our real-life evaluation of PVAG regimen showed that patients were older than those included in the pivotal clinical trial and 58% of patients received adapted-dose of chemotherapy. We confirmed the favorable safety profile of this protocol. Using TEP-scan evaluation, the CR rate was 52%. Survival analyses supported initial results obtained in clinical trial. Combinations with immunotherapies with clinical activity in cHL should be evaluated to improve results of this regimen. Disclosures Brice: Takeda: Consultancy; Roche: Consultancy. Salles:Epizyme: Honoraria, Other: consultancy or advisory role; Kite, a Gilead Company: Honoraria, Other: consultancy or advisory role ; Janssen: Honoraria, Other: consultancy or advisory role; BMS/Celgene: Honoraria, Other: consultancy or advisory role; Takeda: Honoraria; Karyopharm: Honoraria; Genmab: Honoraria, Other; Debiopharm: Consultancy, Honoraria, Other: consultancy or advisory role; MorphoSys: Honoraria, Other: consultancy or advisory role; Novartis: Honoraria, Other: consultancy or advisory role; Roche: Honoraria, Other: consultancy or advisory role; Abbvie: Other: consultancy or advisory role; Autolos: Other: consultancy or advisory role. Deau Fischer:Takeda: Consultancy; Roche: Consultancy.

The Landscape of microRNA Expression in HIV and Non-HIV Associated Classical Hodgkin Lymphoma through Next Generation Sequencing

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 2639-2639
Author(s):  
Paul G. Rubinstein ◽  
Andrea B. Moffitt ◽  
Kelly A. Petrowski ◽  
Marina Messinger ◽  
Nicholas Davis ◽  
...  
Keyword(s):  
Overall Survival ◽  
Next Generation Sequencing ◽  
Hodgkin Lymphoma ◽  
Microrna Expression ◽  
Hiv Positive ◽  
Classical Hodgkin Lymphoma ◽  
Next Generation ◽  
Mixed Cellularity ◽  
Nodular Sclerosis ◽  
Generation Sequencing

Abstract Introduction Classical Hodgkin lymphoma (cHL) is a lymphoma of B cell origin that affects both immune competent and immune suppressed patients. In this study, we sought to determine the complete landscape of microRNA expression in cHL, by performing deep sequencing of microRNAs in 66 patient samples. Further, we examined the associations of microRNA expression with clinical data, including HIV and EBV infection status, mixed cellularity and nodular sclerosis subtypes, and progression free and overall survival. Methods This cohort includes 66 cases of cHL of primarily mixed cellularity and nodular sclerosis subtypes. Nearly 50% of these cases were EBV positive and 39% were HIV positive. All the EBV(-), HIV(-) cases were nodular sclerosis subtype and nearly half of EBV(+), HIV(+) cases were mixed cellularity subtype. From these cases, whole RNA was extracted from which small RNAs were selected via bead purification and subjected to next generation sequencing on the Illlumina platform. MicroRNA expression was assayed by mapping sequencing reads to the human genome and identifying those reads with matching sequences that were typical of a hairpin loop that characterizes microRNA precursors. We were able to identify 367 human microRNAs and 15 EBV microRNAs. The expression of these microRNAs was measured by normalizing the number of sequencing reads mapping to microRNAs within each case and across all the cases. Interestingly, we also found 18 novel microRNAs that have not been described previously in humans. We tested the association of these microRNAs with progression-free and overall survival, as well as with histology, HIV and EBV status. Results We found a number of microRNAs that were robustly associated with stage. miR-138, miR-182, and miR-296 were associated with lower stage across all histologies, whereas miR-378 was strongly associated with higher stage. We found that miR-92b, miR-138 and miR-186 were all associated with favorable prognosis with higher expression being associated with better outcomes. We also found several microRNAs associated with histologic subtype. For example, miR-122 and miR-182 were highly expressed in nodular sclerosis cHL while miR211 was expressed highly in mixed cellularity cHL. miR-21 was highly expressed in all cases. EBV positive cases were defined in all tumors using in situ hybridization using an EBER probe. We found that expression of EBER was highly associated with EBV BART microRNAs, which were present in 100% of the EBV positive patients. We found that miR-455 was highly expressed in HIV positive cases regardless of EBV status whereas miR-511 was expressed highly in all EBV cases in addition to EBV BART microRNAs. Conclusion Together, our data define the landscape of microRNA expression in HIV-associated and non-HIV-associated classical Hodgkin lymphoma and point to a role for microRNAs as novel biomarkers that distinguish histology, stage, outcome and EBV status. Disclosures No relevant conflicts of interest to declare.

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