家庭医学与医学科学研究
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Lymphopenia in Hodgkin Lymphoma is the Consequence the Disease Progression or the Cause of the Disease Progression?

Hasan Khalil1*, Firas Hussein2

Classical Hodgkin Lymphoma (cHL) has many distinctive characters, which could make it the most suitable cancer to investigate the precise role of the immune system in tumor incidence and progression. There are two hypotheses to explain the relationship between lymphopenia and poor prognosis. Knowing the mechanism that links lymphopenia with disease progression could have very important clinical applications. This study includes 84 classical hodgkin lymphoma patients. Patients were followed for 2 years. This period is considered sufficient for assessing progression of hodgkin lymphoma. Lymphopenia was associated with the presence of B symptoms, elevated Lactate Dehydrogenase (LDH) values and higher eosinophil counts. There was a significant difference in progression free survival between high Absolute Lymphocyte Count (ALC) group and low ALC group, and we find that Attributable Risk (AR) was equal to 35.7%. This study supports the hypothesis that the lymphopenia is caused by progression of the disease, mostly by inducing a defect in the secretion of cytokines, which causes an increase in lymphocyte death. We recommend conducting clinical trials to investigate the effectiveness of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) or anti-cytokines as effective drugs in Hodgkin's lymphoma.