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Adverse prognostic significance of CD20 positive Reed–Sternberg cells in classical Hodgkin's disease *
Author(s) -
Portlock Carol S.,
Donnelly Gerard B.,
Qin Jing,
Straus David,
Yahalom Joachim,
Zelenetz Andrew,
Noy Ariela,
O'Connor Owen,
Horwitz Steven,
Moskowitz Craig,
Filippa Daniel A.
Publication year - 2004
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.2004.04964.x
Subject(s) - medicine , cd20 , abvd , multivariate analysis , univariate analysis , white blood cell , gastroenterology , lymphoma , chemotherapy , vincristine , cyclophosphamide
Summary The prognostic significance of CD20 positive classical Hodgkin's disease (cHD) is uncertain. All cHD cases referred to the Memorial Sloan–Kettering Cancer Center (MSKCC) were retrospectively identified (5/92–11/00); the samples were immunostained, and clinical data ascertained. Cases were re‐reviewed without knowledge of clinical outcome. Univariate and multivariate analyses were performed 248 patients had cHD: 28 CD20 + (11%); 220 CD20 − . All clinical characteristics were comparable except haemoglobin level at presentation. With a median follow‐up of 29·2 months, significant prognostic factors in multivariate analysis were: CD20 positivity, elevated white blood cell count (WBC) and low absolute lymphocyte count for time‐to treatment failure (TTF); and for overall survival (OS), CD20 positivity, elevated WBC count, bone marrow involvement and age ≥45 years. TTF was significantly poorer for ABVD‐treated patients with CD20 + cHD as compared with CD20 − cHD. Among 167 patients treated at MSKCC, both TTF ( P < 0·0001) and OS ( P = 0·017) were significantly decreased in CD20 + patients as compared with CD20 − cHD. CD20 + cHD is a poor prognostic factor for TTF and OS. All cHD cases should be immunophenotyped for CD20. A large prospective trial is needed to confirm these findings.