Immunohistochemistry in the therapeutic decision for Hodgkin’s lymphoma

Abstract

Hodgkin's lymphoma is a highly curable malignant hemopathy in both adults and children with therapy adapted to risk factors, including both chemotherapy and radiotherapy. Through effective and curable therapeutic schemes there is a huge potential to improve the vital prognosis and the quality of life in the long term. 15-20% of patients in early stages (stages I, II) and 35-40% of those in advanced stages (III and IV) have relapses or resistance to first-line therapy. Molecular analysis of the cells facilitated the discovery that classical Hodgkin lymphoma, in the vast majority of cases, and predominantly lymphocytic lymphoma present clonal abnormalities derived from the germinal center of B cells. RS cells and their mononuclear variants – Hodgkin cells (HRS) demonstrate an antigenic expression without lineage specificity: CD 15(Leu-M1) and CD 30 (Ki-1). Immunohistochemistry helps to identify the two major categories of Hodgkin's lymphomas. The diagnosis of Hodgkin's lymphoma requires a histopathological examination on a lymph node biopsy or, more rarely, a biopsy for extranodal determination of the disease. The identification of Reed-Sternberg cells and their variants is essential for establishing the histological diagnosis of Hodgkin lymphoma. Comparative study (retrospective and prospective) of two groups of patients with Hodgkin's Lymphoma: Lot 1 – with favorable evolution; Lot 2 – refractory/relapsed/partial remission cases. Study groups – 80 patients diagnosed with classical Hodgkin's lymphoma over a 10-year period, between 2007-2017: – Lot 1-53 patients with a favorable evolution – in complete remission after the first line of treatment; – Lot 2-27 patients with unfavorable evolution (relapsed/refractory/partial remission cases).