Case Report: Sequential lymphomas: may HLA system play a role in this uncommon phenomenon?

Area of Science:

• Hematology
• Immunogenetics
• Oncology

Background:

• The sequential diagnosis of diffuse large B-cell lymphoma (DLBCL) and classical Hodgkin lymphoma (cHL) is uncommon.
• Human leukocyte antigen (HLA) associations with lymphoma susceptibility are increasingly recognized.

Observation:

• Eight patients with sequential DLBCL and cHL were analyzed for clinical characteristics and HLA profiles.
• A median interval of 6.5 years was observed between the first and second lymphoma diagnoses.
• Specific HLA alleles, HLA-DQB1*03:01 and HLA-B*35:03, were identified in a subset of patients.

Findings:

• Four patients were positive for HLA-DQB1*03:01, with three subsequently developing a third lymphoma.
• Three patients carried the HLA-B*35:03 allele.
• Both identified HLA alleles have prior associations with autoimmune conditions.

Implications:

• The findings suggest a potential, though not definitively proven, link between specific HLA alleles and the development of sequential lymphomas.
• HLA typing may represent a valuable area for future research in patients diagnosed with multiple, sequential lymphoid malignancies.
• Further investigation is warranted to elucidate the role of HLA genetics in the pathogenesis of sequential DLBCL and cHL.