The prognostic relevance of apoptosis-related proteins in classical Hodgkin's lymphomas

Leuk Lymphoma. 2003 Mar;44(3):483-8. doi: 10.1080/1042819021000037958.

Abstract

Neoplastic cells in classical Hodgkin's lymphomas (cHL) seem to correspond to defective germinal center B-cells, which escape from apoptosis. Epstein-Barr virus (EBV) may be implicated in this protective mechanism. The aim of the present study was to determine the expression of apoptosis-related proteins in cHL among adult patients and correlate them with EBV expression, clinical findings and survival. EBV was detected by in situ hybridization (Epstein-Barr Encoded RNA, EBER, probe). Immunohistochemistry was used on paraffin sections to detect LMP-1/EBV, CD15 and the apoptosis-related proteins (bcl-2, bax, bcl-X, mcl-1 and CD95). Seventy-eight patients seen at our Institution were studied: 36 male and 42 female. Median age was 31 years (15-75 years). Histological types of cHL were: 61 nodular sclerosis (47 NS1 and 14 NS2), 15 mixed cellularity (MC), 1 lymphocyte depletion and 1 unclassified. In 50 cases there was EBV expression (64%). At least one apoptosis-associated protein was expressed in 92% and CD15 in 57.7% of the cases. In the univariate analysis, the following variables were related to a better overall survival: expression of CD15 (p = 0.023), expression of mcl-1 protein (p = 0.029), expression of bcl-2 protein (p = 0.028, only in a Cox model after stratification for histology) and expression of LMP-1 (p = 0.042). EBV expression presented a borderline inverse correlation with bcl-2. A prognostic index (PI) developed in the present study revealed that simultaneous expression of bcl-2, mcl-1 and LMP-1 was significant and independently correlated with an excellent survival.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Apoptosis*
  • Biomarkers
  • Epstein-Barr Virus Infections / metabolism
  • Female
  • Hodgkin Disease / metabolism*
  • Hodgkin Disease / mortality
  • Hodgkin Disease / pathology
  • Hodgkin Disease / virology
  • Humans
  • Lewis X Antigen / analysis*
  • Life Tables
  • Male
  • Middle Aged
  • Myeloid Cell Leukemia Sequence 1 Protein
  • Neoplasm Proteins / analysis*
  • Prognosis
  • Proportional Hazards Models
  • Proto-Oncogene Proteins / analysis
  • Proto-Oncogene Proteins c-bcl-2 / analysis*
  • RNA, Viral / analysis
  • Retrospective Studies
  • Survival Analysis
  • Tumor Virus Infections / metabolism
  • Viral Matrix Proteins / analysis
  • bcl-2-Associated X Protein
  • bcl-X Protein
  • fas Receptor / analysis

Substances

  • BAX protein, human
  • BCL2L1 protein, human
  • Biomarkers
  • EBV-associated membrane antigen, Epstein-Barr virus
  • Epstein-Barr virus encoded RNA 1
  • Epstein-Barr virus encoded RNA 2
  • Lewis X Antigen
  • Myeloid Cell Leukemia Sequence 1 Protein
  • Neoplasm Proteins
  • Proto-Oncogene Proteins
  • Proto-Oncogene Proteins c-bcl-2
  • RNA, Viral
  • Viral Matrix Proteins
  • bcl-2-Associated X Protein
  • bcl-X Protein
  • fas Receptor