The distinction between chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) with isolated Hodgkin/Reed–Sternberg cells (CLL-HRS; background milieu with a paucity of inflammatory cells) and overt transformation to classic Hodgkin lymphoma (CLL-HL; mixed inflammatory background) is incompletely understood. This retrospective study examined the clinicopathologic features of CLL-HRS (n = 15) and CLL-HL (n = 31) patients seen over the past three decades from a single institution. The phenotypic features of Reed–Sternberg cells in both groups were similar, including expression of CD30, CD15, and PAX5, as well as EBV status. However, a spectrum of background CLL/SLL infiltration amongst the HRS cells was noted on pathologic review, and four patients had both diagnoses, either concurrently or in succession. The median overall survival (OS) of patients with CLL-HRS was 17.5 months compared to 33.5 months for patients with CLL-HL (P = 0.24). Among patients with CLL-HRS, those who received Hodgkin-directed therapy had a significantly longer median OS (57 months) compared to those who received CLL-directed therapy (8.4 months, P = 0.02). Our clinical and pathologic findings suggest a biologic continuum between CLL-HRS and CLL-HL and indicate that CLL-HRS patients may benefit from Hodgkin-directed therapy.
慢性淋巴细胞白血病/小淋巴细胞淋巴瘤（CLL/SLL）中仅出现霍奇金/里德-施特恩伯格细胞（CLL-HRS；背景环境中炎症细胞稀少）与明确转化为经典型霍奇金淋巴瘤（CLL-HL；混合性炎症背景）之间的区别尚未完全阐明。这项回顾性研究分析了单一机构过去三十年间诊治的CLL-HRS（15例）与CLL-HL（31例）患者的临床病理特征。两组中里德-施特恩伯格细胞的表型特征相似，包括CD30、CD15和PAX5的表达以及EBV状态。然而，病理检查发现HRS细胞间存在不同程度的背景性CLL/SLL浸润谱系变化，且有4例患者同时或先后被诊断出两种疾病。CLL-HRS患者的中位总生存期（OS）为17.5月，而CLL-HL患者为33.5月（P=0.24）。在CLL-HRS患者中，接受霍奇金淋巴瘤靶向治疗者的中位OS（57月）显著长于接受CLL靶向治疗者（8.4月，P=0.02）。我们的临床与病理研究结果提示CLL-HRS与CLL-HL之间存在生物学连续性，并表明CLL-HRS患者可能从霍奇金淋巴瘤靶向治疗中获益。
肿瘤(癌症)患者之家