Hodgkin Lymphoma (HL) is characterized by an inflammatory background in which the reactive myeloid cells may exert an immune-suppressive effect related to the progression of the disease. Immunoglobulin M is the first antibody isotype produced during an immune response, which also plays an immunoregulatory role. Therefore, we investigated if, as a surrogate of defective B cell function, it could have any clinical impact on prognosis. In this retrospective, observational, single–center study, we evaluated 212 newly diagnosed HL patients, including 132 advanced-stage. A 50 mg/dL level of IgM at baseline resulted in 84.1% sensitivity and 45.5% specificity for predicting a complete response in the whole cohort (area under curve (AUC) = 0.62,p= 0.013). In multivariate analysis, baseline IgM ≤ 50 mg/dL and the presence of a large nodal mass (<7 cm) were independent variables able to predict the clinical outcome, while, after two cycles of treatment, IgM ≤ 50 mg/dL at baseline and PET-2 status were independent predictors of PFS. The amount of IgM at diagnosis is a valuable prognostic factor much earlier than PET-2, and it can also provide information for PET-2-negative patients. This can help to identify different HL classes at risk of treatment failure at baseline.
霍奇金淋巴瘤（HL）的特征在于其炎症背景中，反应性髓系细胞可能发挥与疾病进展相关的免疫抑制作用。免疫球蛋白M是免疫反应中最早产生的抗体同种型，同样具有免疫调节作用。因此，我们探讨了其作为B细胞功能缺陷的替代指标，是否对预后具有临床影响。在这项回顾性、观察性、单中心研究中，我们评估了212例新诊断的HL患者，其中包括132例晚期患者。基线IgM水平为50 mg/dL时，预测整个队列完全缓解的敏感性为84.1%，特异性为45.5%（曲线下面积（AUC）= 0.62，p=0.013）。在多变量分析中，基线IgM ≤ 50 mg/dL和大淋巴结肿块（≥7 cm）的存在是预测临床结果的独立变量；而在两个周期治疗后，基线IgM ≤ 50 mg/dL和PET-2状态是无进展生存期的独立预测因子。诊断时的IgM水平是一个比PET-2更早的有价值的预后因素，并且也能为PET-2阴性患者提供信息。这有助于在基线时识别不同类别、存在治疗失败风险的HL患者。
肿瘤(癌症)患者之家