PMID- 23207618
OWN - NLM
STAT- MEDLINE
DCOM- 20130605
LR  - 20151119
IS  - 1423-0240 (Electronic)
IS  - 0378-584X (Linking)
VI  - 35
IP  - 12
DP  - 2012
TI  - Prognostic significance of Bcl-2, tumor-associated macrophages, and total 
      neoplastic and inflammatory lymph node involvement in advanced stage classical 
      Hodgkin's lymphoma.
PG  - 733-9
LID - 10.1159/000343664 [doi]
AB  - BACKGROUND: Although Hodgkin's lymphoma (HL) is a curable cancer, current 
      treatment strategies based on risk stratification and response modulation are not 
      precise enough. The predictive power of biological and morphological parameters 
      is controversial, with prognostic models not reaching wide acceptance. PATIENTS 
      AND METHODS: We analyzed the prognostic relevance of 8 parameters in 85 advanced 
      stage classical HL patients, in order to determine whether tissue-based variables 
      could add prognostic value to standard clinical parameters, thus contributing to 
      better risk stratification at presentation. RESULTS: Univariate analysis 
      confirmed 5 indicators of shorter overall survival (OS): Bcl-2 overexpression; 
      increased CD68+ tumor-associated macrophages (TAM); international prognostic 
      score (IPS) > 2; bulky disease; and total lymph node involvement (TLNI) with 
      regard to neoplastic and inflammatory cells. Apart from TLNI, these parameters 
      influenced lower event-free survival (EFS). Multivariate analysis identified 5 
      independent factors for OS: Bcl-2 overexpression; increased CD68+ TAM; TLNI; IPS 
      > 2; and bulky disease. Increased CD68+ TAM, IPS > 2, and bulky disease affected 
      the EFS. Utilizing the cumulative score of unfavorable prognostic factors for OS, 
      we designed a prognostic model stratifying patients into 4 risk groups (with 0-1, 
      2, 3, or 4-5 factors), each with progressively reduced OS (p < 0.001). 
      CONCLUSION: Our findings support the combination of tissue-based variables with 
      clinical parameters at diagnosis, identifying patients who are at higher risk of 
      poor outcome.
FAU - Jakovic, Ljubomir R
AU  - Jakovic LR
AD  - Clinic for Hematology, Clinical Center of Serbia, Belgrade, Serbia. 
      ljubajak@yahoo.com
FAU - Mihaljevic, Biljana S
AU  - Mihaljevic BS
FAU - Jovanovic, Maja D Perunicic
AU  - Jovanovic MD
FAU - Bogdanovic, Andrija D
AU  - Bogdanovic AD
FAU - Andjelic, Bosko M
AU  - Andjelic BM
FAU - Bumbasirevic, Vladimir Z
AU  - Bumbasirevic VZ
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20121120
PL  - Switzerland
TA  - Onkologie
JT  - Onkologie
JID - 7808556
RN  - 0 (Biomarkers, Tumor)
RN  - 0 (Proto-Oncogene Proteins c-bcl-2)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Biomarkers, Tumor/*analysis
MH  - Comorbidity
MH  - Female
MH  - Hodgkin Disease/*mortality/pathology/*physiopathology
MH  - Humans
MH  - Lymphangitis/*mortality/pathology/*physiopathology
MH  - Lymphatic Metastasis
MH  - Macrophages/*pathology
MH  - Male
MH  - Middle Aged
MH  - Prevalence
MH  - Prognosis
MH  - Proto-Oncogene Proteins c-bcl-2/*analysis
MH  - Risk Factors
MH  - Serbia/epidemiology
MH  - Survival Analysis
MH  - Survival Rate
MH  - Young Adult
EDAT- 2012/12/05 06:00
MHDA- 2013/06/06 06:00
CRDT- 2012/12/05 06:00
PHST- 2012/12/05 06:00 [entrez]
PHST- 2012/12/05 06:00 [pubmed]
PHST- 2013/06/06 06:00 [medline]
AID - 000343664 [pii]
AID - 10.1159/000343664 [doi]
PST - ppublish
SO  - Onkologie. 2012;35(12):733-9. doi: 10.1159/000343664. Epub 2012 Nov 20.