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Significance of CD68 Tumor Infiltrating Macrophages in Pediatric Classical Hodgkin Lymphoma
Ale H1,2*, Zapata CP3, Castellano-Sanchez AA4,5, Poppiti RJ4,5, Brathwaite C4,6, Escobar RA7, Zapata CM8, De Angulo GR2,9
1Division of Pediatric Immunology and Allergy, Joe DiMaggio Children’s Hospital, Hollywood, FL
2Department of Pediatrics, Florida International University, Herbert Wertheim College of Medicine, Miami, FL
3Division of Pediatric Oncology, Children’s Hospital of Philadelphia, Philadelphia, PA
4Department of Pathology, Florida International University, Herbert Wertheim College of Medicine, Miami, FL
5Division of Pathology, Mount Sinai Medical Center, Miami Beach, Florida
6Division of Pathology, Nicklaus Children’s Hospital, Miami, FL
7University of Medical Sciences of Havana, Havana, Cuba
8Florida State University, Tallahassee Florida
9Division of Hematology/Oncology, Nicklaus Children’s Hospital, Miami, FL
Corresponding Author: Hanadys Ale, MD
Address: 1131 North 35th Avenue, 2nd floor, Hollywood, Fl 33021, Phone: 954-265-3030; E-mail: hanadys.ale@mch.com
Received date: 15 October 2019; Accepted date: 06 November 2019; Published date: 12 November 2019
Citation: Ale H, Zapata CP, Castellano-Sanchez AA, Poppiti RJ, Brathwaite C, Escobar RA, Zapata CM, De Angulo GR. Significance of CD68 Tumor Infiltrating Macrophages in Pediatric Classical Hodgkin Lymphoma. Asp J Pediatrics Child Health. 2019 Nov 11;1(1):31-39.
Copyright © 2019 2019 Ale H, Zapata CP, Castellano-Sanchez AA, Poppiti RJ, Brathwaite C, Escobar RA, Zapata CM, De Angulo GR. This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium provided the original work is properly cited.
Key Words: CD68; Tumor Associate Macrophages; Pediatric Hodgkin Lymphoma; Prognosis
Abstract
Background: Hodgkin Lymphoma (HL) represents a disease of successful outcome due to advances in modern medicine. A significant percentage of patients respond very well to treatment, achieving relapse free survival. However, despite appropriate treatments as many as 20% of these patients die of this disease. Risk stratification allows therapy to be selected based on specific prognostic indicators.
Procedure: A retrospective cohort study containing 25 pediatric classical HL cases were evaluated from the files of Miami Children’s Hospital Department of Pathology. The study aimed to analyze tumor-associated macrophages via CD68 immunohistochemistry in tissue obtained at the time of diagnosis. It studied the prognostic value of CD68+ histiocytes against a patient’s response to treatment and survival rates, as a possible correlation of this biomarker with outcomes.
Results: Higher levels of CD68+ macrophages was strongly correlated with a significant probability of relapsing from complete response (P=0.005), along with a greater likelihood of death from lymphoma (P=0.024). Furthermore, survival analysis demonstrated a decreased progression-free survival (P=0.001) and disease specific survival (P=0.023) when the microenvironment showed elevation of these macrophages.
Conclusions: The presence of an increased expression of CD68+ macrophages was found to be associated with a worse prognosis in a pediatric patient with HL. This study, establishes a new use for CD68, as a reliable immunohistochemical marker in pediatric patients with equivalent predictor outcomes as those reported in adult cases. This biomarker helps to identify those pediatric patients at higher risk of treatment failure, and thus provide the basis for individualized patient treatment.