BCL-2 expression in Hodgkin and Reed-Sternberg cells of classical Hodgkin disease predicts a poorer prognosis in patients treated with ABVD or equivalent regimens

George Z. Rassidakis, L. Jeffrey Medeiros, Theodoros P. Vassilakopoulos, Simonetta Viviani, Valeria Bonfante, Gianpaolo Nadali, Marco Herling, Maria K. Angelopoulou, Roberto Giardini, Marco Chilosi, Christos Kittas, Timothy J. McDonnell, Gianni Bonadonna, Alessandro M. Gianni, Giovanni Pizzolo, Gerassimos A. Pangalis, Fernando Cabanillas, Andreas H. Sarris

Research output: Contribution to journalArticle

Abstract

To determine the clinical significance of BCL-2 expression in Hodgkin-Reed-Sternberg (HRS) cells of classical Hodgkin disease (cHD), we correlated its expression with presenting clinical and laboratory features and failure-free survival (FFS). Eligible patients were untreated and negative for HIV-1; they had biopsyproven cHD. BCL-2 expression was determined immunohistochemically in available pretreatment tissue biopsy specimens without knowledge of clinical outcome. Tumors were considered positive if any HRS cells expressed BCL-2. We identified 707 patients with cHD, whose median age was 30 years; 54% were men. HRS cells expressed BCL-2 in 359 (65%) of 551 nodular sclerosis, 67 (47%) of 143 mixed cellularity, and all 5 lymphocyte depletion. For all patients, the 5-year FFS was 74% versus 84% for tumors with versus without BCL-2 expression (P = .0016, by log-rank test). For the 412 patients treated with adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD) or equivalent regimens, the 5-year FFS for tumors with versus without BCL-2 expression was 74% versus 88% (P = .001, by log-rank test); for the 233 patients with Ann Arbor stage I or II, FFS was 84% versus 92% (P = .04, by log-rank test); and for the 179 patients with Ann Arbor stage III or IV, FFS was 62% versus 81% (P = .006, by log-rank test). Multivariate analysis confirmed that BCL-2 expression is independently associated with inferior FFS along with age 45 or older, Ann Arbor stage IV, low serum albumin and high serum lactate dehydrogenase levels. We conclude that BCL-2 is frequently expressed by HRS cells in cHD and is associated with inferior FFS in patients treated with ABVD or equivalent regimens.

Original languageEnglish
Pages (from-to)3935-3941
Number of pages7
JournalBlood
Volume100
Issue number12
DOIs
Publication statusPublished - Dec 1 2002

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Reed-Sternberg Cells
Dacarbazine
Vinblastine
Bleomycin
Hodgkin Disease
Doxorubicin
Tumors
Survival
Lymphocytes
Biopsy
L-Lactate Dehydrogenase
Serum Albumin
Lymphocyte Depletion
Tissue
Neoplasms
Sclerosis
HIV-1
Multivariate Analysis

ASJC Scopus subject areas

  • Hematology

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BCL-2 expression in Hodgkin and Reed-Sternberg cells of classical Hodgkin disease predicts a poorer prognosis in patients treated with ABVD or equivalent regimens. / Rassidakis, George Z.; Medeiros, L. Jeffrey; Vassilakopoulos, Theodoros P.; Viviani, Simonetta; Bonfante, Valeria; Nadali, Gianpaolo; Herling, Marco; Angelopoulou, Maria K.; Giardini, Roberto; Chilosi, Marco; Kittas, Christos; McDonnell, Timothy J.; Bonadonna, Gianni; Gianni, Alessandro M.; Pizzolo, Giovanni; Pangalis, Gerassimos A.; Cabanillas, Fernando; Sarris, Andreas H.

In: Blood, Vol. 100, No. 12, 01.12.2002, p. 3935-3941.

Research output: Contribution to journalArticle

Rassidakis, GZ, Medeiros, LJ, Vassilakopoulos, TP, Viviani, S, Bonfante, V, Nadali, G, Herling, M, Angelopoulou, MK, Giardini, R, Chilosi, M, Kittas, C, McDonnell, TJ, Bonadonna, G, Gianni, AM, Pizzolo, G, Pangalis, GA, Cabanillas, F & Sarris, AH 2002, 'BCL-2 expression in Hodgkin and Reed-Sternberg cells of classical Hodgkin disease predicts a poorer prognosis in patients treated with ABVD or equivalent regimens', Blood, vol. 100, no. 12, pp. 3935-3941. https://doi.org/10.1182/blood.V100.12.3935
Rassidakis, George Z. ; Medeiros, L. Jeffrey ; Vassilakopoulos, Theodoros P. ; Viviani, Simonetta ; Bonfante, Valeria ; Nadali, Gianpaolo ; Herling, Marco ; Angelopoulou, Maria K. ; Giardini, Roberto ; Chilosi, Marco ; Kittas, Christos ; McDonnell, Timothy J. ; Bonadonna, Gianni ; Gianni, Alessandro M. ; Pizzolo, Giovanni ; Pangalis, Gerassimos A. ; Cabanillas, Fernando ; Sarris, Andreas H. / BCL-2 expression in Hodgkin and Reed-Sternberg cells of classical Hodgkin disease predicts a poorer prognosis in patients treated with ABVD or equivalent regimens. In: Blood. 2002 ; Vol. 100, No. 12. pp. 3935-3941.
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abstract = "To determine the clinical significance of BCL-2 expression in Hodgkin-Reed-Sternberg (HRS) cells of classical Hodgkin disease (cHD), we correlated its expression with presenting clinical and laboratory features and failure-free survival (FFS). Eligible patients were untreated and negative for HIV-1; they had biopsyproven cHD. BCL-2 expression was determined immunohistochemically in available pretreatment tissue biopsy specimens without knowledge of clinical outcome. Tumors were considered positive if any HRS cells expressed BCL-2. We identified 707 patients with cHD, whose median age was 30 years; 54{\%} were men. HRS cells expressed BCL-2 in 359 (65{\%}) of 551 nodular sclerosis, 67 (47{\%}) of 143 mixed cellularity, and all 5 lymphocyte depletion. For all patients, the 5-year FFS was 74{\%} versus 84{\%} for tumors with versus without BCL-2 expression (P = .0016, by log-rank test). For the 412 patients treated with adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD) or equivalent regimens, the 5-year FFS for tumors with versus without BCL-2 expression was 74{\%} versus 88{\%} (P = .001, by log-rank test); for the 233 patients with Ann Arbor stage I or II, FFS was 84{\%} versus 92{\%} (P = .04, by log-rank test); and for the 179 patients with Ann Arbor stage III or IV, FFS was 62{\%} versus 81{\%} (P = .006, by log-rank test). Multivariate analysis confirmed that BCL-2 expression is independently associated with inferior FFS along with age 45 or older, Ann Arbor stage IV, low serum albumin and high serum lactate dehydrogenase levels. We conclude that BCL-2 is frequently expressed by HRS cells in cHD and is associated with inferior FFS in patients treated with ABVD or equivalent regimens.",
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T1 - BCL-2 expression in Hodgkin and Reed-Sternberg cells of classical Hodgkin disease predicts a poorer prognosis in patients treated with ABVD or equivalent regimens

AU - Rassidakis, George Z.

AU - Medeiros, L. Jeffrey

AU - Vassilakopoulos, Theodoros P.

AU - Viviani, Simonetta

AU - Bonfante, Valeria

AU - Nadali, Gianpaolo

AU - Herling, Marco

AU - Angelopoulou, Maria K.

AU - Giardini, Roberto

AU - Chilosi, Marco

AU - Kittas, Christos

AU - McDonnell, Timothy J.

AU - Bonadonna, Gianni

AU - Gianni, Alessandro M.

AU - Pizzolo, Giovanni

AU - Pangalis, Gerassimos A.

AU - Cabanillas, Fernando

AU - Sarris, Andreas H.

PY - 2002/12/1

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N2 - To determine the clinical significance of BCL-2 expression in Hodgkin-Reed-Sternberg (HRS) cells of classical Hodgkin disease (cHD), we correlated its expression with presenting clinical and laboratory features and failure-free survival (FFS). Eligible patients were untreated and negative for HIV-1; they had biopsyproven cHD. BCL-2 expression was determined immunohistochemically in available pretreatment tissue biopsy specimens without knowledge of clinical outcome. Tumors were considered positive if any HRS cells expressed BCL-2. We identified 707 patients with cHD, whose median age was 30 years; 54% were men. HRS cells expressed BCL-2 in 359 (65%) of 551 nodular sclerosis, 67 (47%) of 143 mixed cellularity, and all 5 lymphocyte depletion. For all patients, the 5-year FFS was 74% versus 84% for tumors with versus without BCL-2 expression (P = .0016, by log-rank test). For the 412 patients treated with adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD) or equivalent regimens, the 5-year FFS for tumors with versus without BCL-2 expression was 74% versus 88% (P = .001, by log-rank test); for the 233 patients with Ann Arbor stage I or II, FFS was 84% versus 92% (P = .04, by log-rank test); and for the 179 patients with Ann Arbor stage III or IV, FFS was 62% versus 81% (P = .006, by log-rank test). Multivariate analysis confirmed that BCL-2 expression is independently associated with inferior FFS along with age 45 or older, Ann Arbor stage IV, low serum albumin and high serum lactate dehydrogenase levels. We conclude that BCL-2 is frequently expressed by HRS cells in cHD and is associated with inferior FFS in patients treated with ABVD or equivalent regimens.

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