DNA aneuploidy and cell proliferation in relation to histology and prognosis in patients with Hodgkin's disease

Background: Aneuploidy and S-phase fraction are well recognized prognostic features of solid tumors and non-Hodgkin's lymphoma. However, only limited data on Hodgkin's disease are available. Patients and methods: In this study flow cytometric data on ploidy status and S-phase fraction are analyzed in relation to clinical characteristics and prognosis in 137 patients with Hodgkin's disease. Results: The presence of DNA aneuploidy was not associated with other clinical characteristics. When the histologic subtypes were clustered according to a higher number of Reed-Sternberg/Hodgkin cells into two classes (LP + NSI and the histologic NSII + MC + LD), it appeared that cases with an SPF ≥ 7.5% had the histologic subtypes NSII + MC + LD significantly more frequently than those with an SPF <7.5% (P = 0.001). There was no significant difference in complete remission rates, relapse-free or overall survivals between the patients with diploid and those with aneuploid lymph nodes. The complete remission rate for patients with an SPF <7.5% was higher than for those with an SPF ≥ 7.5%: 95% (56/59) and 76% (50/66), respectively (P = 0.006). The 10-year survival rate was 78% for patients with an SPF <7.5% and 48% for those with an SPF ≥7.5% (P = 0.04). However, by multivariate analysis only the ESR, age and clinical stage proved to be of independent prognostic importance. Conclusion: DNA aneuploidy did not correlate with known prognostic factors or survival, but the SPF might turn out to be an indicator of patients who will have less favourable outcomes.