Classical Hodgkin lymphoma (cHL) accounts for 0.4% of all new cancer cases globally. Despite high cure rates with standard treatment, approximately 15% of patients still experience relapsed or refractory (RR) disease, and many of these eventually die from lymphoma-related causes. Exciting new targeted agents such as anti-PD-1 agents and brentuximab vedotin have changed the therapeutic paradigm beyond chemotherapy and radiotherapy alone. Advances in understanding of the molecular biology are providing insights in the context of novel therapies. The signature histology of cHL requires the presence of scant malignant Hodgkin Reed–Sternberg cells (HRSCs) surrounded by a complex immune-rich tumour microenvironment (TME). The TME cellular composition strongly influences outcomes, yet knowledge of the precise characteristics of TME cells and their interactions with HRSCs is evolving. Novel high-throughput technologies and single-cell sequencing allow deeper analyses of the TME and mechanisms elicited by HRSCs to propagate growth and avoid immune response. In this review, we explore the evolution of knowledge on the prognostic role of immune cells within the TME and provide an up-to-date overview of emerging prognostic data on cHL from new technologies that are starting to unwind the complexity of the cHL TME and provide translational insights into how to improve therapy in the clinic.
经典型霍奇金淋巴瘤（cHL）约占全球新发癌症病例的0.4%。尽管标准治疗方案治愈率较高，仍有约15%的患者出现复发或难治性（RR）疾病，其中多数最终死于淋巴瘤相关病因。抗PD-1药物和维布妥昔单抗等新型靶向药物的出现，改变了单纯依靠化疗和放疗的治疗模式。对分子生物学认识的深入为新型疗法提供了理论依据。cHL的特征性组织学表现为稀少的恶性霍奇金-里德-斯特恩伯格细胞（HRSCs）被复杂的免疫富集肿瘤微环境（TME）所包绕。TME的细胞构成强烈影响疾病转归，但关于TME细胞精确特征及其与HRSCs相互作用的认识仍在不断发展。新型高通量技术和单细胞测序技术使得对TME及HRSCs促进肿瘤生长、逃避免疫应答机制的深入分析成为可能。本综述探讨了TME中免疫细胞预后作用认知的演进过程，并基于新兴技术提供的cHL预后数据，系统阐述了当前对cHL肿瘤微环境复杂性的最新认识，为临床治疗策略的改进提供了转化医学视角。
Prognostic Markers within the Tumour Microenvironment in Classical Hodgkin Lymphoma
肿瘤(癌症)患者之家