Follicular Dendritic Cells Have Prognostic Relevance in Hodgkin’s Disease

Abstract

The authors' previous study showed the presence of follicular dendritic cell (FDC) networks--though altered--in neoplastic areas, not only in the nodular lymphocyte predominance type, but also in other types of Hodgkin's disease. The present retrospective study was performed on 102 patients to determine whether the presence or absence of FDC networks, or parts of them, in neoplastic areas has prognostic relevance in Hodgkin's disease. Follicular dendritic cells were visualized with the monoclonal antibody Ki-FDC1P, which selectively stains FDCs in paraffin-embedded tissues. Univariate statistical analysis, in which nodular sclerosis (NS) and mixed cellularity (MC) types were combined, showed three prognostically different groups: the best prognosis was associated with nodular lymphocyte predominance cases; the worst with FDC-negative NS or MC cases; and an intermediate prognosis with FDC-positive NS or MC cases. In the NS group, the prognosis of FDC-positive cases was better than that of FDC-negative cases. After multivariate analysis, stepwise modeling identified three prognostic factors at diagnosis: stage (P = .001), FDC status (P = .001), and age (P = .06). The authors conclude that in the most common types of Hodgkin's disease (nodular lymphocyte predominance, NS, and MC), FDC status in the neoplastic area(s) bears prognostic relevance, a positive FDC status predicting a favorable prognosis and a negative FDC status an unfavorable one.

Follicular dendritic cells: origin, function, and different disease-associated patterns

“…The absence of the meshworks in the lymphocyte-depleted subtype is thought to be due to the loss of the ability of the Hodgkin cells to bind to the FDCs, which as discussed above, are needed for antigen presentation and for B-and T-cell survival, and as a result, progressive break-up of the FDC meshworks may partly be responsible for the lymphocytic depletion [66]. Earlier studies have examined the association of FDCs with the clinical outcome in patients with CHL, and an intermediate prognosis was reported in FDC-positive cases by immunohistochemistry (44% of the cases studied) compared to a guarded prognosis for the FDC-negative cases [67]. Similar results were reported in another study, although it was mainly confined to the nodular sclerosis subtype of CHL, where the authors reported the presence of FDC meshworks, whether intact or disrupted, in about 70% of their cases and that the cases with intact FDC meshworks exhibited relatively better prognosis than those with disrupted meshworks and a much better prognosis than those with absent FDC staining by immunohistochemistry [66].…”

Pathobiology of Hodgkin Lymphoma

“…The secretion of cytokines by neoplastic cells is currently believed to cause the progressive attraction of T cells, histiocytes, plasma cells, and eosinophils, which give rise to nodules replacing the pre-existing follicles and produce the typical pattern of NS-cHL. Within the nodules, there are numerous FDCs, which seem to represent a favourable prognostic indicator [112, 113]. …”

Dendritic Cells in Barrett’s Esophagus and Esophageal Adenocarcinoma

“…The infiltration of dendritic cells into some primary tumor types has been found to be associated with significantly improved patient survival and a reduced incidence of recurrent disease, indicating an important immune-regulating role for dendritic cells in the local tumor environment. [26][27][28][29][30][31][32][33][34][35] Furthermore, dendritic cells can be used to manipulate immune responses, including those for cancer immunotherapy.…”