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Background: Limited progress had been made in prognostic stratification of patients with Hodgkin lymphoma (HL) until recent studies suggested that the number of CD68-expressing macrophages is prognostic in classical HL. However, its significance in Asian patients with HL has not been explored yet perhaps because of its low incidence in Asia. Methods: In this work, we performed immunohistochemical analysis of CD163, as well as CD68, in 144 Korean patients with HL treated between November 1990 and December 2009 in a single center. The relative percentages of CD68+ and CD163+ cells with respect to the overall cellularity (CD68 index and CD163 index, respectively) were correlated with clinical outcomes. Results: Both high CD68 and CD163 indices (>20%) were associated with a rise in treatment-related deaths and poorer event-free survival ( P = 0.009 and P = 0.0023, respectively), disease-specific survival ( P = 0.011 and P = 0.001), and overall survival ( P = 0.023 and P = 0.001). In particular, a high CD163 index was related to lower complete response (CR) rate ( P = 0.022) and shorter duration of CR ( P = 0.030). Conclusions: High index of either CD68 or CD163 (>20%) is significantly correlated with poor prognosis in Korean patients with HL. CD163, a specific marker of macrophages, seems to be another prognostic factor for classical HL. [ABSTRACT FROM AUTHOR]