IntroductionClassical Hodgkin lymphoma (HL) is a lymphoid neoplasm that stems from the clonal expansion of mononuclear Hodgkin cells and multinuclear Reed-Sternberg cells expressing the CD30 antigen. 1 Malignant Hodgkin and Reed-Sternberg (HRS) cells usually constitute less than 10% of the neoplastic mass. 2 The remaining tissue is composed of a reactive cellular infiltrate. Although rare cases with T-cell genotype have been described, 3,4 the vast majority of classical HL tumors is thought to originate from transformed germinal center (GC) B cells, because their HRS component harbors a monoclonal immunoglobulin (Ig) gene rearrangement and somatically mutated Ig V region genes. 1,[5][6][7] Despite their GC B-cell origin, HRS cells lack many molecules usually expressed by B cells and are incapable of producing functional Igs. [7][8][9][10][11][12] While nonmalignant B cells that have lost their capacity to express Igs rapidly undergo apoptosis, 13 malignant HRS cells survive. This abnormal survival is thought to be due to dysregulated activation of nuclear factor B (NF-B), 14-18 a transcription factor essential for the development of both normal and neoplastic B cells. 19,20 In classical HL, the reactive infiltrate is composed of nonmalignant T cells, B cells, plasma cells, and myeloid cells, including macrophages and granulocytes. 2,21 These cells are thought to enhance HRS cell growth through cytokines and tumor necrosis factor (TNF) family members, such as CD30 ligand (CD30L), receptor activator of NF-B ligand (RANKL), and CD40 ligand (CD40L). 15,[22][23][24][25][26][27][28][29] Recent studies show that myeloid cells express B-cell-activating factor of the TNF family (BAFF, also known as BLyS) and its homolog APRIL, a proliferation-inducing ligand, [30][31][32][33] 2 molecules essential for the survival, proliferation, and differentiation of B cells and plasma cells. 34,35 BAFF activates B cells and plasma cells by binding to transmembrane activator and calcium modulator and cyclophylin ligand interactor (TACI), B-cell maturation antigen (BCMA), and BAFF receptor (BAFF-R) receptors. APRIL activates B cells and plasma cells by binding to TACI and BCMA, but not BAFF-R. 36 By recruiting TNF receptor-associated factor (TRAF) adaptor molecules, TACI, BCMA, and BAFF-R activate an IB kinase (IKK) complex that in turn elicits phosphorylation-dependent degradation of inhibitor of NF-B (IB), which retains p50, c-Rel, and p65 NF-B proteins in a cytoplasmic inactive form. [37][38][39] IB degradation causes NF-B nuclear translocation and transcriptional activation of NF-B-responsive genes involved in B-cell survival, proliferation, and maturation. 31,[39][40][41] Of note, recent studies show that APRIL signaling via TACI and BCMA receptors is reinforced by heparan sulfate proteoglycans (HSPGs) anchored on the cell membrane or associated with the extracellular matrix. 35,42,43 The role of TACI, BCMA, BAFF-R, and HSPGs in HL remains unknown.BAFF and APRIL are implicated in B-cell neoplasias, 44-52 including non-Hodgkin lymph...