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Frontiers in Hodgkin Lymphoma

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Dear Colleagues,

Hodgkin’s lymphoma (HL) is a well-forecasted, highly curable hematologic malignancy that is usually diagnosed in young adults. However, one-third of cases eventually relapses and needs salvage therapy regimens. Patients chemoresistant and/or relapsing after ASCT are a significant challenge to face as standard strategies are quite disappointing in this setting. However, we are entering an exciting new era where new drugs or approaches may change the dismal prognosis of relapsing/refractory cases. Antibody-based conjugated therapies such as Brentuximab Vedotin directed against CD30 or bi-specific antibodies, such as AFM13 that link CD16a and CD30 cells, have improved the specificity of salvage therapy in HL. Immune checkpoint inhibitors may overcome the immune tolerance to this malignancy, and promising emergent adaptive immunotherapies based on chimeric antigen T cells (CAR-Ts) may step in where chemotherapy fails. The challenge will be to define an optimal algorithm for all specific situations using precision medicine. In this Special Issue, original research articles and reviews are welcome.

Research areas may include (but are not limited to) the following:

Radiation therapy for Hodgkin’s lymphoma;
Surveillance of Hodgkin’s lymphoma;
Therapeutic targets for Hodgkin’s lymphoma;
Combination chemotherapy for Hodgkin’s lymphoma;
New Adaptive immunotherapies.

We look forward to receiving your contributions.

Dr. Antonio Gutierrez
Guest Editor

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11 pages, 586 KiB

Open AccessArticle

Influence of Sociodemographic Determinants on the Hodgkin Lymphoma Baseline Characteristics in Long Survivors Patients Enrolled in the Prospective Phase 3 Trial AHL2011

by Steeve Chevreux, Sandra de Barros, Camille Laurent, Amandine Durand, Cyrille Delpierre, Philippine Robert, Clémentine Joubert, Samuel Griolet, Salim Kanoun, Jean-Noël Bastie, René-Olivier Casasnovas and Cédric Rossi

Cancers 2023, 15(1), 53; https://doi.org/10.3390/cancers15010053 - 22 Dec 2022

Cited by 1 | Viewed by 1999

Abstract

Introduction: Whereas numerous studies on several cancers describe the link between social conditions and disease severity, little is known about the social and demographic characteristics of Hodgkin lymphoma (HL) patients. At diagnosis, 10–15% of the patients in the advanced stages have a well-known poor outcome owing to their chemoresistance, but the determinants of the more advanced stages remain elusive. The objective of the present study was to decipher the potential impact of social disparities on the disease features at diagnosis and analyze how the sociodemographic patient features could impact the HL outcome of patients with advanced-stage HL enrolled in the AHL2011 trial. Methods: This ancillary study was conducted on a cohort of patients from French centers that had recruited more than five patients in the phase III AHL2011 study (NCT0135874). Patients had to be alive at the time of the ancillary study and had to have given their consent to answer the questionnaire. Pre-treatment data (age, gender, stage, B symptoms, IPS), the treatment received, the responses to PET-CT, and the presence of serious adverse events (serious adverse events—SAEs) were all extracted from the AHL2011 trial database. Sociodemographic data—marital status, living area, level of education, socio-professional category, and professional situation—were extracted from the questionnaires. The population density at the point of diagnosis was determined based on ZIP Code, and the distance from the reference medical center was then calculated by the road network. Baseline PET acquisition was performed before any treatment. PET images at baseline were centrally reviewed. The total metabolic tumor volume (TMTV) at the baseline was calculated using a 41% SUVmax cutoff for each lesion. Progression-free survival was defined as the time from randomization to the first progression, relapse, or death from any cause or the last follow-up. The data cutoff for the analyses presented here was 31 October 2017. The progression-free survival was analyzed on an intention-to-treat basis. Results: Among the 823 patients enrolled in the AHL2011 study, the questionnaire was sent to 394 patients, of whom 232 (58.9%) responded. At the time of HL diagnosis, 61.9% (N = 143) of patients declared that they were not socially isolated, 38.1% (N = 88) that they were single, 163 (71.2%) had a professional activity, and 66 (28.8%) were inactive owing to unemployment, retirement, or sick leave. Of the patients, 31.1% (N = 71) lived in a rural region, compared to 68.9% (N = 157) that lived in an urban region. The residence ZIP Code at the time of HL diagnosis was available for 163 (70%). Sociodemographic characteristics did not influence the presence of usual prognostic factors (ECOG, B symptoms, bulky mass, IPS) except for professional activity, which was associated with more frequent low IPS (0–2) (79 (48.5%) active versus 20 (30.3%) inactive patients; p = 0.012). Likewise, no correlation was observed between TMTV and sociodemographic characteristics. However, the TMTV quartile distribution was different according to the living area, with the two upper quartiles being enriched with patients living in a rural area (p = 0.008). Moreover, a negative correlation between the average number of the living area’s inhabitants and TMTV (R Pearson = −0.29, p = 0.0004) was observed. Conclusion: This study focused on sociodemographic parameters in advanced-stage HL patients and shows that professional activity is associated with more favorable disease features (low IPS), while patients living in rural or low-populated areas are more likely to have an unfavorable HL presentation with a high tumor burden (high TMTV). These data suggest that some patient sociodemographic characteristics might impact either access to medical care or environmental exposure, leading to a higher frequency of unfavorable presentations. Further prospective sociodemographic studies are necessary to confirm these preliminary results. Full article

(This article belongs to the Special Issue Frontiers in Hodgkin Lymphoma)

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Open AccessSystematic Review

Plasticity in Classical Hodgkin Composite Lymphomas: A Systematic Review

by Alexis Trecourt, Marie Donzel, Juliette Fontaine, Hervé Ghesquières, Laurent Jallade, Gabriel Antherieu, Camille Laurent, Claire Mauduit and Alexsandra Traverse-Glehen

Cancers 2022, 14(22), 5695; https://doi.org/10.3390/cancers14225695 - 19 Nov 2022

Cited by 6 | Viewed by 2582

Abstract

The co-occurrence of several lymphomas in a patient defines composite/synchronous lymphoma. A common cellular origin has been reported for both contingents of such entities. In the present review, we aimed to gather the available data on composite lymphomas associating a classical Hodgkin lymphoma (cHL) with another lymphoma, to better understand the plasticity of mature B and T-cells. This review highlights that >70% of patients with a composite lymphoma are ≥55 years old, with a male predominance. The most reported associations are cHL with follicular lymphoma or diffuse large B-cell lymphoma, with over 130 cases reported. The cHL contingent is often of mixed cellularity type, with a more frequent focal/weak CD20 expression (30% to 55.6%) compared to de novo cHL, suggesting a particular pathophysiology. Moreover, Hodgkin cells may express specific markers of the associated lymphoma (e.g., BCL2/BCL6 for follicular lymphoma and Cyclin D1 for mantle cell lymphoma), sometimes combined with common BCL2/BCL6 or CCND1 rearrangements, respectively. In addition, both contingents may share similar IgH/IgK rearrangements and identical pathogenic variants, reinforcing the hypothesis of a common clonal origin. Finally, cHL appears to be endowed with a greater plasticity than previously thought, supporting a common clonal origin and a transdifferentiation process during lymphomagenesis of composite lymphomas. Full article

(This article belongs to the Special Issue Frontiers in Hodgkin Lymphoma)

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