From the Guidelines
Yes, Hodgkin lymphoma is generally considered a B-cell lymphoma. Hodgkin lymphoma originates from B lymphocytes, specifically from germinal center or post-germinal center B cells. The characteristic feature of Hodgkin lymphoma is the presence of Reed-Sternberg cells, which are abnormal B cells that have undergone malignant transformation. While Hodgkin lymphoma cells often lose expression of many B-cell markers, genetic and molecular studies have confirmed their B-cell origin, as noted in the most recent guidelines 1. The cells typically retain some B-cell characteristics and express CD30 and CD15, which are key diagnostic markers. It's essential to distinguish between the two main types of Hodgkin lymphoma: classical Hodgkin lymphoma (CHL) and nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL), with CHL accounting for 95% of cases in Western countries 1. Understanding Hodgkin lymphoma as a B-cell malignancy is crucial for its diagnosis, classification, and the development of targeted therapies that exploit B-cell-specific pathways. Key considerations in the management of Hodgkin lymphoma include the stage and subtype of the disease, as well as the potential long-term effects of treatment, with cure rates exceeding 80% in many cases 1. The treatment approach for Hodgkin lymphoma usually involves chemotherapy (often ABVD regimen: Adriamycin, Bleomycin, Vinblastine, Dacarbazine) and/or radiation therapy, depending on the stage and subtype of the disease, with ongoing clinical trials focusing on improving cure rates and reducing long-term toxicity 1. Some subtypes, such as lymphocyte-predominant Hodgkin lymphoma (LPHL), have distinct immunophenotypic features, including CD20 positivity, which can inform treatment decisions 1. Overall, recognizing Hodgkin lymphoma as a B-cell lymphoma is vital for providing effective and targeted care to patients with this disease.
From the Research
Definition and Characteristics of Hodgkin Lymphoma
- Hodgkin Lymphoma (HL) is considered a B-cell lymphoma, as the malignant cells are derived from B cells 2, 3.
- The disease is characterized by the presence of rare tumor cells, known as Hodgkin and Reed-Sternberg (HRS) cells, which are surrounded by a dense immune microenvironment 4, 5.
- Despite being derived from B cells, HRS cells have largely lost their B-cell phenotype and exhibit a unique co-expression of markers from various hematopoietic cell types 3, 5.
Comparison with Other B-cell Lymphomas
- While HL shares a common cell of origin with other B-cell lymphomas, it exhibits distinct differences in morphology, cellular composition, immunophenotype, and clinical behavior 6.
- These differences suggest that HL should be considered a separate category from other B-cell non-Hodgkin lymphomas (B-NHL) 6.
Molecular Biology and Pathogenesis
- The pathogenesis of HL involves the deregulation of multiple signaling pathways and transcription factors, including the NF-κB and JAK/STAT pathways 2, 3, 5.
- Genetic lesions affecting these pathways, as well as interactions with the microenvironment, contribute to the development and progression of HL 3, 5.
- The unique biology of HL may offer opportunities for targeted therapies, including immune-based approaches 2, 5.