Analysis of NF-κB Pathway Proteins in Pediatric Hodgkin Lymphoma : Correlations with EBV Status and Clinical Outcome—A Children's Oncology Group Study

الملخص EN

Constitutively active nuclear factor-κB (NF-κB) is integral to the survival of Hodgkin/Reed-Sternberg cells (H/RS) in Hodgkin lymphoma (HL).

To investigate NF-κB pathway proteins in pediatric HL, we utilized a tissue microarray compiled from 102 children enrolled in the Children's Oncology Group intermediate-risk clinical trial AHOD0031 (56 male, 78 Caucasian, median age 15 years (range 1–20 years), 85 nodular sclerosing subtype, 23 Epstein-Barr virus (EBV) positive, and 24 refractory/relapsed disease).

We examined the intensity, localization, and pathway correlations of NF-κB pathway proteins (Rel-A/p65, Rel-B, c-Rel, NF-κB1, NF-κB2, IκB-α, IKK-α, IKK-β, IKK-γ/NEMO, NIK, and A20), as well as their associations with EBV status and clinical outcome.

NF-κB pathway proteins were overexpressed in pediatric HL patients compared to controls.

Patients with EBV− tumors, or with rapid early therapy response, had tightly coordinated regulation of NF-κB pathway proteins, whereas patients with EBV+ tumors, or slow early therapy response, had little coordinated NF-κB pathway regulation.

High NIK expression was associated with a slow response to therapy and decreased EFS.

Elevated Rel-B, NIK, and the NF-κB inhibitor A20 were associated with decreased EFS in multivariate analysis.

These studies suggest a pivotal role for the NF-κB pathway in therapy response and patient survival in Hodgkin lymphoma.