Human germinal center-associated lymphoma protein expression is associated with improved failure-free survival in Brazilian patients with classical Hodgkin lymphoma

Abstract

The human germinal center-associated lymphoma (HGAL) gene has prognostic value in diffuse large B-cell lymphoma, and expression of its cognate protein is germinal center-specific. A previous study had suggested that HGAL protein expression might also be related to the outcome in patients with Hodgkin lymphoma (HL). The aim of this study was to confirm the prognostic impact of HGAL protein expression in an independent, well-characterized cohort of 232 patients with classic HL treated uniformly with doxorubicin, bleomycin, vinblastine and dacarbazine (ABVD). Tissue microarray analysis showed HGAL staining in 188 specimens (81%). Failure-free survival (FFS) was superior in patients with early-stage disease, low-risk IPS, and HGAL-positive patients. The estimated 5-year FFS for HGAL-positive and HGAL-negative patients was 82% and 67%, respectively (p = 0.03). In the multivariate analysis, advanced stage and absence of HGAL staining were independent predictors of a worse FFS. This study confirms and validates recent findings of a correlation between HGAL expression and outcome in classical HL.

Keywords:

• HGAL
• Hodgkin lymphoma
• survival
• prognosis
• tissue microarray

Acknowledgments

We are indebted to Fernando Augusto Soares MD, PhD and to Carlos Ferreira do Nascimento from the Department of Pathology of Hospital do Cancer A. C. Camargo for the TMA construction.

Declaration of interest: DA was supported by a CAPES/PDEE grant; ISL is supported by National Institutes of Health (NIH, Bethesda, MD) CA109335, NIH CA 122105, and NIH U56 CA112973 and Dwoskin Family Foundation (Miami, FL); IB is supported by Faperj grant 171.243/2006; YN is supported by grant NIH POI CA34233; NS is supported by Faperj grant 102.900/2008, and CNPq grant 302708/2008-1.