Retrospective analysis of the prognostic role of tissue eosinophil and mast cells in Hodgkin’s lymphoma

Abstract

The composition of reactive cell populations, which constitute the majority of tumor load in Hodgkin's lymphoma (HL), can influence the prognosis of the disease. Besides widely accepted and applied prognostic scores, the authors evaluate biological factors that may have a prognostic impact. Previous data indicate that the rate of eosinophils and mast cells in the reactive cell population, determined already at diagnosis, can be used for this purpose. Histological samples from 104 patients with HL with an average follow-up period of 110 (24-214) months were retrospectively analyzed. Mast cell positivity was associated with better overall survival, although this difference was only of borderline statistical significance (p=0.092). No significant difference was found in parameters like overall survival (OS, p=0.906) or event-free survival (EFS, p=0.307) of eosinophil-positive vs. -negative cases or in EFS (p=0.742) of mast cell-positive vs. -negative individuals (criterion for a positive specimen was more than 5% of appropriate cells in the reactive cell population). Looking at the effect of eosinophilia and mastocytosis together, there was no significant difference between the subgroups categorized according to the combined presence of the two cell types. It seems that tissue eosinophil and mast cell predominance have no prognostic value that could be used in clinical practice, although a tendency for correlation of mast cell positivity with overall survival could be seen. For a definitive statement, multicenter studies should be performed involving a higher number of patients suffering from HL.

Increased programmed death-1+ tumor-infiltrating lymphocytes in classical Hodgkin lymphoma substantiate reduced overall survival

“…Recent studies suggest that recruited inflammatory cells may provide essential feedback signals to the neoplastic cells and thus represent important lymphoma/host microenvironment modulators [1][2][3][4][5]11]. The most convincing in vivo observation in support of this hypothesis is that provided by Biggar et al [15], who showed that HIV+ patients with low CD4 + cell counts had a significantly lower risk of developing classical Hodgkin lymphoma compared with those with high CD4 + cell counts.…”

“…One study has shown that patients with high levels of Granzyme B and T-cell restricted antigen-1 (TIA-1)+ cells have an unfavorable clinical course [2]. Other studies on the role of mast cells in classical Hodgkin lymphoma suggest that mast cells are associated with poorer overall survival or that higher mast cell infiltration results in lower relapse-free survival [3,4]. FOXP3 is a marker for a subset of CD4 + CD25 + regulatory T cells (Tregs) in the tumor microenvironment.…”

Role of mast cells in fibrosis of classical Hodgkin lymphoma

“…Keresztes et al reported that mast cell infiltration was similar in MCCHL and NSCHL. 28 On the other hand, some authors reported that NSCHL correlated with higher numbers of tumor-infiltrating mast cells, compared with non-NSCHL. [29][30][31] Immunodeficient NOD/SCID mice inoculated with both mast cells and human HRS cells grew tumors with a more marked fibrotic component, compared with tumors in mice inoculated with HRS cells alone.…”

Tumour‐associated mast cells in classical Hodgkin's lymphoma: correlation with histological subtype, other tumour‐infiltrating inflammatory cell subsets and outcome

“…In addition, Molin et al . found high numbers of mast cells to be associated with poor prognosis in Hodgkin's lymphoma, although this finding was not confirmed by a separate group . In an earlier study, Molin and co‐authors had shown that mast cells are able to stimulate HRS cell lines in vitro via CD30 ligand–CD30 interaction.…”

“…In cHL, high numbers of intratumoral mast cells have been shown to be associated with nodular sclerosis (NS) subtype histology (7), while a more recent study found somewhat lower numbers of mast cells in EBV-positive tumours, compared to EBVnegative tumours (8). In addition, Molin et al (7) found high numbers of mast cells to be associated with poor prognosis in Hodgkin's lymphoma, although this finding was not confirmed by a separate group (9). In an earlier study, Molin and co-authors had shown that mast cells are able to stimulate HRS cell lines in vitro via CD30 ligand-CD30 interaction.…”