Cell cycle characteristics and Epstein-Barr virus are differentially associated with aggressive and non-aggressive subsets of Hodgkin lymphoma in pediatric patients

MÁRIO HENRIQUE M. BARROS; ADRIANA SCHELIGA; ELENA DE MATTEO; CAROLINA MINNICELLI; FERNANDO A. SOARES; ILANA R. ZALCBERG; ROCIO HASSAN

LEUKEMIA AND LYMPHOMA

TAYLOR & FRANCIS LTD

Año: 2010 vol. 51 p. 1513 - 1522

1042-8194

We investigated the correlation of tumor characteristics with clinico-biological markers of aggressive disease, evaluated by Ann Arbor stage, risk group, B-symptoms, number of involved anatomic areas, mediastinal mass, nodular sclerosis (NS) grade, and risk, in pediatric Hodgkin lymphoma (HL). Leukopenia and extranodal disease influenced event-free survival (p¼0.032 and p¼0.041). In multivariate analysis, extranodal disease was associated with high number of tumor-infiltrating eosinophils (p¼0.035) and Ki67550% (p¼0.024); B-symptoms with Ki67"75% (p¼0.027) and high LDH levels (p¼0.001); and mediastinal mass with leukopenia (p¼0.048), NS grade II (p¼0.025), and high-risk (p¼0.046). Furthermore, low stages correlated with Ki67"50% (p¼0.005) and Epstein?Barr virus (EBV) (p¼0.065). Low-risk NS was associated with EBV (p¼0.014). Hierarchical cluster analysis identified two clusters, one composed of high-risk patients and cell cycle and apoptosis features, and the other including low-risk patients, EBV, and low-risk NS. Our results show the association of biological markers with disease aggressiveness in pediatric HL.