Variant histology,IgD and CD30 expression in low‐risk pediatric nodular lymphocyte predominant Hodgkin lymphoma: A report from the Children's Oncology Group |
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| Authors: | Ramona Vesna Untanu Jason Back Burton Appel Qinglin Pei Lu Chen Allen Buxton David C. Hodgson Peter F. Ehrlich Louis S. Constine Cindy L. Schwartz Robert E. Hutchison |
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| Affiliation: | 1. Division of Clinical Pathology, Department of Pathology, State University of New York Upstate Medical University, Syracuse, New York;2. Department of Pathology, Chatham‐Kent Health Alliance, Chatham, Ontario, Canada;3. Hematology/Oncology, Institute for Pediatric Cancer & Blood Disorders, Joseph M. Sanzari Children's Hospital, Hackensack University Medical Center, Hackensack, New Jersey;4. Children's Oncology Group, Department of Biostatistics, University of Florida, Gainesville, Florida;5. Department of Information Sciences, City of Hope, Duarte, California;6. Statistics, Children's Oncology Group, Monrovia, California;7. Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada;8. Department of Surgery, University of Michigan, Ann Arbor, Michigan;9. Department of Radiation Oncology, University of Rochester, Rochester, New York;10. Children's Hospital of Wisconsin, Department of Oncology, Milwaukee, WI, University of Texas MD Anderson Cancer Center, Houston, Texas |
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| Abstract: | 1 Background Histologic prognostic factors have been described for nodular lymphocyte predominant Hodgkin lymphoma (NLPHL). This study examines histologic and immunophenotypic variants in a clinical trial for pediatric NLPHL. 2 Procedure One hundred sixty‐eight cases of localized NLPHL were examined for histologic variants, CD30 and immunoglobulin D (IgD) expression, and outcome. Histologic types were scored categorically as 0 = 0, 1 ≤ 25%, and 2 > 25% of the sample. 3 Results Fifty‐eight (35.1%) cases showed only typical nodular with or without serpiginous histology (types A and B). The remainder showed mixtures of histologies. The numbers of patients with score 2 are 85 (50.6%) type A, 21 (12.5%) type B, 46 (27.4%) with extranodular large B cells (type C), 3 with T‐cell‐rich nodular pattern (type D), 55 (32.7%) with diffuse T‐cell‐rich (type E) pattern, and 2 (1.2%) with diffuse B‐cell pattern (type F). Higher level of types C (P = 0.048) and D (P = 0.033) resulted in lower event‐free survival (EFS). Cytoplasmic IgD was found in 65 of 130 tested (50%), did not significantly associate with EFS but positively correlated with types C and E histology (P < 0.0001) and negatively correlated with types A (P = 0.0003) and B (P = 0.006). Seventeen (10%) expressed CD30, with no adverse effect. 4 Conclusions Variant histology is common in pediatric NLPHL, especially types C and E, which are associated with IgD expression. Type C variant histology and possibly type D are associated with decreased EFS, but neither IgD nor CD30 are adverse features. Variant histology may warrant increased surveillance, but did not affect overall survival. |
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| Keywords: | children histology Hodgkin lymphoma pathology |
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