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The resistance and progression of tumors in patients with classic Hodgkin lymphoma is believed at least in part to depend on features of the tumor microenvironment. However, the relationship between malignant Hodgkin/Reed-Sternberg cells, reactive populations, and immune cells is still unclear. This retrospective study, published in Cancers, sought to identify potential predictive and prognostic morphological markers in the treatment of patients with relapsed or refractory classic Hodgkin lymphoma treated with nivolumab.

The study relied on 61 samples of lymph nodes from patients who had relapsed/refractory classic Hodgkin lymphoma and were treated with nivolumab. The median follow-up was 55 months. Overall response rates to therapy depended on various protein expressions in the tumor microenvironment. The combination of CD163/c-maf antibodies was used to identify M2 macrophages. 

Ultimately, the researchers found a significant relationship between a low number of tumor-associated macrophages and inferior progression-free survival during nivolumab treatment. Additionally, a low level of M2 macrophages significantly correlated with progression-free survival and complete response during nivolumab treatment. Lastly, following nivolumab treatment, PD-1 positive T cells and LAG-3 -positive T cells increased, while macrophages decreased.

These findings are important because they add to our understanding of the Hodgkin lymphoma microenvironment during nivolumab treatment [1].


[1] Gusak, A., Fedorova, L., Lepik, K., Volkov, N., Popova, M., Moiseev, I., Mikhailova, N., Baykov, V., & Kulagin, A. (2021). Immunosuppressive microenvironment and efficacy of PD-1 inhibitors in relapsed/refractory classic Hodgkin lymphoma: checkpoint molecules landscape and macrophage populations. Cancers, 13(22), 5676. https://doi.org/10.3390/cancers13225676

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