1. MAL is expressed in a subset of Hodgkin lymphoma and identifies a population of patients with poor prognosis
- Author
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Marek Skacel, Elisa Tso, Miguel A. Alonso, Eric D. Hsi, Paul Elson, Carlos Alemany, Brad Pohlman, and Stephen J. Sup
- Subjects
Oncology ,Adult ,Male ,medicine.medical_specialty ,Pathology ,Lymphoma, B-Cell ,Proteolipids ,Population ,Mediastinal Neoplasms ,Disease-Free Survival ,Nodular sclerosis ,Internal medicine ,medicine ,Biomarkers, Tumor ,Humans ,Clinical significance ,B-cell lymphoma ,education ,Neoplasm Staging ,education.field_of_study ,Chlorambucil ,business.industry ,Proportional hazards model ,Myelin and Lymphocyte-Associated Proteolipid Proteins ,Germinal center ,Membrane Transport Proteins ,General Medicine ,Middle Aged ,medicine.disease ,Combined Modality Therapy ,Hodgkin Disease ,Immunohistochemistry ,Lymphoma ,Survival Rate ,Tissue Array Analysis ,lipids (amino acids, peptides, and proteins) ,Female ,Lymphoma, Large B-Cell, Diffuse ,business ,Myelin Proteins ,medicine.drug - Abstract
Classic Hodgkin lymphoma (cHL) and mediastinal (thymic) large B-cell lymphoma (MLBL) have clinical, histopathologic, and molecular genetic similarities. MAL, a gene that encodes a protein associated with lipid rafts in T and epithelial cells, is overexpressed in a majority of MLBLs and has been reported in a minority of cHLs. To study the clinical significance of MAL in cHL, we immunostained 86 cases; 16 cHLs (19%) expressed MAL. Expression correlated with nodular sclerosis subtype, and within this subtype, with grade 2 histology. Univariable analysis revealed association of age of 45 years or older, MAL expression, and an International Prognostic Score of more than 2 with worse failure-free survival. Age of 45 years or older, MAL expression, and stage III or IV were associated with worse overall survival (OS). Cox proportional hazards modeling showed age (P = .04 and P = .03, respectively) and MAL expression (P = .03 and P = .01, respectively) as independent predictors of failure-free survival and OS. Stage was of borderline significance in OS (P = .08). MAL expression seems to identify a subset of cHL with an adverse outcome and provides additional evidence for a link between cHL and MLBL. In the vast majority of cases, Hodgkin lymphoma (HL) is a B-cell lymphoma that is derived from germinal center stage B cells that have defective immunoglobulin transcription. 1 Studies suggest a relationship between HL and mediastinal (thymic) large B-cell lymphoma (MLBL), a particular type of diffuse large B-cell lymphoma (DLBL). 2-4 HL and MLBL share many
- Published
- 2006