This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Tzankov, A. Articles by Dirnhofer, S. Search for Related Content PubMed PubMed Citation Articles by Tzankov, A. Articles by Dirnhofer, S.

Prognostic Significance of CD20 Expression in Classical Hodgkin Lymphoma

A Clinicopathological Study of 119 Cases¹

Institute of Pathology [A. T., J. K.] and Department of Hematology and Oncology and the Tyrolean Cancer Research Institute [M. F., R. G.], University of Innsbruck, A-6020 Innsbruck, Austria; Institute of Pathology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany [F. F.]; and Institute of Pathology, University of Basel, Basel, Switzerland [S. D.]

Purpose: Recent evidence has demonstrated that classical Hodgkin lymphoma (cHL) originates from mature germinal center B cells. However, only 25% of cHLs express the classical B-cell marker CD20. There is very little, and controversial, information on the prognostic significance of CD20 expression in cHL with regard to failure-free (FFS) and overall survival (OS).

Experimental Design: CD20 expression was investigated in a series of 119 cases of cHL treated at a single institution where complete clinical follow-up was available. The results were correlated to FFS and OS by the Kaplan-Maier method and uni- and multivariate analyses.

Results: Hodgkin and Reed-Sternberg cells expressed CD20 in 20% (24 of 119) of the cases based on a cutoff of 10% positivity. Within a mean follow-up period of 12 years, univariate analysis revealed a significantly higher frequency of disease relapses in the CD20-negative group (30 of 95; 32%) compared with CD20-positive tumors (2 of 24; 8%; P = 0.022). Compared by the log-rank test, the mean FFS in CD20-negative cases (202 months) was considerably shorter than in the CD20-positive cases (286 months; P = 0.0195). In a multivariate analysis, CD20 expression was an independent positive prognostic factor for FFS in cHL patients treated from 1974 to 1980 (P = 0.035). This effect disappeared in the period from 1981 to 1999 (P = 0.266).

Conclusion: CD20-positive cHL shows a trend for better FFS and OS. However, improved treatment modalities seem to abolish these differences.