| Autor: |
Jachimowicz RD; University of Cologne,University Hospital Cologne, Cologne, Germany., Pieper L; University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany., Reinke S; University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany., Gontarewicz A; University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany., Plütschow A; University of Cologneand University Hospital Cologne, German Hodgkin Study Group, Germany., Haverkamp H; University of Cologneand University Hospital Cologne, German Hodgkin Study Group, Germany., Frauenfeld L; Department of Pathology, University of Tübingen, Germany., Fend F; Department of Pathology, University of Tübingen, Germany., Overkamp M; Department of Pathology, University of Tübingen, Germany., Jochims F; University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany., Thorns C; Department of Pathology, University Hospital Schleswig-Holstein, University of Lübeck, Germany., Leo Hansmann M; Department of Pathology, University Hospital Frankfurt, Germany., Möller P; Department of Pathology, University Hospital Ulm, Germany., Rosenwald A; Institute of Pathology, University of Würzburg, Comprehensive Cancer Center Mainfranken, Germany., Stein H; Pathodiagnostik, Berlin, Germany., Reinhardt HC; Cologne Excellence Cluster on Cellular Stress Response in Aging-Associated Diseases, Germany., Borchmann P; University of Cologne, German Hodgkin Study Group, Cologne, Germany., von Tresckow B; University of Cologne, German Hodgkin Study Group, Cologne, Germany., Engert A; University of Cologne, German Hodgkin Study Group, Cologne, Germany., Klapper W; University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany. |
| Abstrakt: |
A subset of patients with advanced-stage classical Hodgkin Lymphoma (cHL) relapse or progress following standard treatment. Given their dismal prognosis, identifying this group of patients upfront represents an important medical need. While prior research has identified characteristics of the tumor microenvironment, which are associated with cHL outcomes, biomarkers that are developed and validated in this high-risk group are still missing. Here, we applied whole-slide image analysis (WSI), a quantitative, large-scale assessment of tumor composition that utilizes conventional histopathology slides. We conducted WSI on a study cohort with pre-treatment biopsies of 340 advanced-stage cHL patients enrolled in the HD12 and HD15 trials of the German Hodgkin Study Group (GHSG), and tested our results in in a validation cohort of 147 advanced-stage cHL patients within the GHSG HD18 trial. All patients were treated with BEACOPP-based regimens. By quantifying T cells, B cells, Hodgkin-Reed-Sternberg-cells and macrophages with WSI, 80% of all cells in the tumor tissue were identified. Crucially, low B cell count was associated with significantly reduced progression-free survival (PFS) and overall survival (OS), while T cell-, macrophage- and Hodgkin-Reed-Sternberg-cell content was not associated with the risk of progression or relapse in the study cohort. We further validated low B cell content as a prognostic factor of PFS and OS in the validation cohort and demonstrate good inter-observer agreement of WSI. WSI may represent a key tool for risk stratification of advanced-stage cHL that can easily be added to the standard diagnostic histopathology work-up. |
