Hodgkin-biomarkers

With this project we hope to identify biomarkers and novel therapeutic targets for pediatric Hodgkin lymphoma.

2.1 Population (base)
All patients with a suspected diagnosis of Hodgkin lymphoma will be offered to participate in this study. Patients that have a confirmed diagnosis of classical Hodgkin Lymphoma will be checked on the inclusion and exclusion for the Hodgkin lymphoma group (paragraph 2.2) . Patients that do not have the diagnosis classical Hodgkin Lymphoma will be checked on the inclusion and exclusion criteria for the control group (paragraph 2.3). If a patient isn’t eligible for both groups this will be considered as a screen failure and remaining bodily material will be destroyed

Although classical Hodgkin Lymphoma (CHL) in pediatric patients has a good prognosis, the outcome is associated with a substantial proportion of treatment-related toxicity and still about 10-20% of the patients progress during or relapse after treatment. Strikingly, therapeutic regimens have not changed much during the past decades. Current treatment protocols rely on chemo- and radiotherapy, whereby patients are classified at diagnosis into three different treatment groups based on a clinical staging system. Radiotherapy can be omitted based on Fluoro-Deoxyglucose-Positron emission tomography CT (PET-CT) treatment response.

HL is considered an immunological disease, where reactive cells in the tumor microenvironment greatly outnumber malignant Hodgkin- and Reed-Sternberg (HRS) cells. The microenvironment supports proliferation and survival of HRS cells. Due to active crosstalk between HRS cells and their microenvironment, serum biomarkers should be detectable and may be a surrogate for lymphoma viability. HL biology impedes development of in vitro and in vivo assays for functional studies to discover new therapeutics. Genetic analysis of malignant Hodgkin cells has been hampered by their scarcity and has largely been done with laser-dissected samples. In addition, apart from a clinical staging system at diagnosis, there have been no prognostic molecular markers to stratify patients into different therapy groups. Taken together this calls for efforts to identify biomarkers and get an in-depth understanding of HL immunology and biology to discover new therapeutic targets en less toxic therapies.

Baseline characteristics

Clinical parameters including age, sex, stages according to the Cotswolds revision of the Ann Arbor staging system, histology and the presence of B symptoms will be collected. The following laboratory parameters will be recorded at time of diagnosis and during follow-up at the same time points as serum and blood samples for biomarker identification are taken: Erythrocyte sedimentation rate (ESR), leukocyte count and differentiation, lymphocyte subpopulations, thrombocyte count, hemoglobin, creatinine, albumin and C-reactive protein. EBV status and treatment regime will be registered at diagnosis.

Blood biomarkers

Serial serum and blood samples will be collected at diagnosis (baseline) and at fixed time points during treatment and follow-up

Not applicable,