http://jst.sciedupress.com Journal of Solid Tumors 2016, Vol. 6, No. 1 ORIGINAL ARTICLES High tumour-associated macrophages infiltration is correlated with poor survival outcome in classical Hodgkin’s lymphoma Jaudah Al-Maghrabi 1, 3 , Wafaey Gomaa ∗1, 2 , Zuhoor Al-Mansouri 3 , Mohamed El-Sayed 4, 6 , Tawfiq El-Khodary 5, 7 1 Department of Pathology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia 2 Department of Pathology, Faculty of Medicine, Minia University, Al Minia, Egypt 3 Department of Pathology, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia 4 Department of Oncology, Radiation Oncology Section, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia 5 Department of Oncology, Medical Oncology Section, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia 6 Department of Radiotherapy and Nuclear Medicine, National Cancer Institute, Cairo University, Cairo, Egypt 7 Oncology Centre, Mansoura University, El Mansoura, Egypt Received: September 12, 2015 Accepted: October 26, 2015 Online Published: November 15, 2015 DOI: 10.5430/jst.v6n1p9 URL: http://dx.doi.org/10.5430/jst.v6n1p9 ABSTRACT Background: Classical Hodgkin’s lymphoma (cHL) represents the majority of HLs with a relatively good prognosis. In 20% of patients, primary treatment fails. Prediction of treatment failure is critical. A gene signature of tumour associated macrophages (TAM) correlated with response to treatment as CD68 positive TAM was found to be associated with shortened survival. We aim to investigate the relation CD68+TAM infiltration to patients’ outcome. Patients and Methods: Pathological materials of 115 patients with cHL were used. Clinical characteristics of patients were collected from the records. CD68 immunostaining was performed to determine the number of infiltrating TAM and subsequently followed by stratification of results. Results of CD68 immunostaining were statistically analysed to correlate the extent of CD68+ TAM infiltration with clinicopathological characteristics, treatment outcome, and patients’ survival. Results: High CD68+TAM infiltration was observed in more patients of cHL (96/115 of patients = 83.5%). High CD68+TAM infiltration was associated with extranodal presentation (P = .001), and higher stage (P = .022). No associations with other clinicopathological parameters were found. High CD68+TAM infiltration was not found to be an independent predictor of treatment outcome. High CD68+TAM infiltration correlated with disease free survival (DFS) (log-rank = 4.505, P = .034) but not with disease specific survival (DSS) (log-rank = 1.371, P = .242). Conclusions: The results of our study support the adverse prognostic effect of high TAM in cHL. Technical standardisation of CD68 immunostaining is required to establish TAM infiltration as a prognostic predictor. Also in vivo and in vitro cHL models have to be established for proper understanding of the role of CD68 in modulating the TAM in cHL. Key Words: Classical Hodgkin’s lymphoma, CD68, Tumour-associated macrophages, Outcome * Correspondence: Wafaey Gomaa; Email: wafgom@mu.edu.eg; Address: Department of Pathology, King Abdulaziz University, P.O. Box 80205, Jeddah 21589, Saudi Arabia. Published by Sciedu Press 9