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Bone marrow is infrequently implicated in early stages of Hodgkin's disease. We studied the immunohistochemical bone marrow tissue of 7 out of 20 cases with early stage Hodgkin's disease of the mixed cellularity variant, diagnosed by lymph node biopsy at initial presentation, not responding to radiotherapy alone, in order to examine possible marrow attack. A statistically significant prevalence of CD45, CD45RO, and CD4 positive infiltrates, to the advantage of unremitting hosts, was found. The predominance of CD4-positive cells in the bone marrow space might be suggestive of involvement in the process and could explain the abnormal cytokine production leading to reduced T-cell immunity and inefficient antitumor response despite the existence of a vast majority of reactive infiltrating immune cells.

Unremitting early stage Hodgkin disease: report of 7 cases and bone marrow tissue immunohistochemical marker study