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Updated: Apr 6, 2026
Flow-sorting and Exome Sequencing of the Reed-Sternberg Cells of Classical Hodgkin Lymphoma
Published on: June 10, 2017
Clinicopathological features of classical Hodgkin lymphoma in patients ≥ 40 years old, with special reference to
Akiko Miyagi Maeshima1, Hirokazu Taniguchi2, Junko Nomoto3
1Department of Pathology, National Cancer Center Hospital, Tokyo akmaeshi@ncc.go.jp.
Insights
Elderly patients (≥ 40 years) with classical Hodgkin lymphoma (cHL) have a 20% incidence of composite lymphomas. Accurate diagnosis and tailored treatment are crucial for improving outcomes in this older population.
Area of Science:
- Oncology
- Hematology
- Pathology
Background:
- Classical Hodgkin lymphoma (cHL) presents bimodal incidence peaks, affecting young adults and the elderly.
- Limited data exists on the clinicopathological characteristics of cHL in elderly patients (≥ 40 years).
Purpose of the Study:
- To analyze the clinicopathological features of elderly patients with cHL.
- To specifically investigate the incidence, histopathology, and outcomes of composite cHL in this age group.
Main Methods:
- Retrospective analysis of 154 cHL patients.
- Focus on patients aged ≥ 40 years, examining demographics, histopathology, and treatment responses.
- Utilized fluorescence in situ hybridization (FISH) for correlation status of composite lymphomas.
Main Results:
- 50 (32%) of 154 cHL patients were ≥ 40 years old.
- The incidence of composite cHL (including with B-cell non-Hodgkin lymphoma) in patients ≥ 40 years was 20% (10/50 patients).
- Five-year progression-free survival was 59% and overall survival was 86% in the elderly cohort.
Conclusions:
- Composite cHL, particularly with B-cell non-Hodgkin lymphoma, occurs in 20% of elderly cHL patients.
- Early and precise diagnosis of composite lymphomas is essential for effective management in older individuals.
- Optimal treatment strategies are critical for improving the prognosis of elderly patients diagnosed with composite cHL.
Objective:
Classical Hodgkin lymphoma shows a peak incidence at 15-35 years, and a second peak in elderly patients; however, pathological characteristics of elderly patients with classical Hodgkin lymphoma have not been analyzed enough.
Methods:
In a total of 154 patients with classical Hodgkin lymphoma, we analyzed the clinicopathological characteristics of classical Hodgkin lymphoma patients aged ≥ 40 years old, with special reference to the incidence, histopathology and outcome of patients with composite classical Hodgkin lymphoma.
Results:
Of 154 patients with classical Hodgkin lymphoma, 50 (32%) were ≥ 40 years old. The 5-year progression-free and overall survival rates were 59 and 86%, respectively. Thirty-eight patients (76%) had non-composite classical Hodgkin lymphoma, 10 patients (20%) had composite (6 simultaneous and 4 consecutive) classical Hodgkin lymphoma and B-cell non-Hodgkin lymphoma and 2 patients (4%) had methotrexate-associated classical Hodgkin lymphoma. Of 10 patients with composite classical Hodgkin lymphoma, composite lymphomas were detected throughout the staging procedure of the upper gastrointestinal tract or bone marrow in 4 patients. Fluorescence in situ hybridization revealed that the composite lymphomas of 4, 1 and 5 patients were related, unrelated and of unknown correlation status, respectively. The treatments after the diagnosis of a classical Hodgkin lymphoma component varied, and three patients died of lymphoma.
Conclusions:
We found that the incidence of composite classical Hodgkin lymphoma in patients ≥ 40 years old was 20%. Correct diagnosis and optimal treatment for patients with composite classical Hodgkin lymphoma and B-cell non-Hodgkin lymphoma is highly important in this patient population.
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