Assessment of CD20 Marker as a Prognostic Predictor for Patients with Classical Hodgkin Lymphoma

Eman Atarji; Yara M Daous; Ahmed Barefah; Hatem Alahwal; Bushra Albaity; Nora Y Hakami; Heba Alkhatabi; Talal Qadah

doi:10.2147/CMAR.S531465

Assessment of CD20 Marker as a Prognostic Predictor for Patients with Classical Hodgkin Lymphoma

Cancer Manag Res. 2025 Aug 22:17:1767-1776. doi: 10.2147/CMAR.S531465. eCollection 2025.

Authors

Eman Atarji^{1

2}, Yara M Daous^{2

3}, Ahmed Barefah^{2

4}, Hatem Alahwal^{2

4}, Bushra Albaity^{2

4}, Nora Y Hakami¹, Heba Alkhatabi^{1

2

5}, Talal Qadah^{1

2

5}

Affiliations

¹ Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
² Hematology Research Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.
³ Department of Pathology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
⁴ Department of Hematology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
⁵ Institute of Genomic Medicine Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.

Abstract

Purpose: Classical Hodgkin Lymphoma (CHL) is a highly curable malignant disease of the lymphoid system. However, some patients may experience a clinical relapse. Biological marker expression may help to predict disease outcomes and guide salvage treatment options. CD20 expression occurs in approximately 30% of CHL cases. The clinical outcomes of patients with CHL and CD20 positivity remain controversial. Therefore, this study aimed to determine the prognostic value of CD20 expression in CHL patients.

Patients and methods: This retrospective study included 52 patients with CHL between 2017-2023 with a median follow-up of 60 months (range: 24-72 months). Immunohistochemistry was performed on formalin-fixed, paraffin-embedded tissue biopsies to assess CD20 expression. Chi-square and Fisher's exact tests were used to analyze categorical data and determine significant differences between the CD20 expression status groups. Overall survival (OS) and Progression-Free Survival (PFS) were assessed using Log rank test. Statistical significance was set at p < 0.05.

Results: Of 52 CHL patients, 11 (21.2%) showed CD20-positive Hodgkin Reed-Sternberg (HRS) cells. Most parameters showed no significant differences between the CD20-positive and CD20-negative groups, except for serum albumin level (p = 0.042). Log-rank analysis for OS and PFS revealed no significant differences between the groups.

Conclusion: CD20 expression in the HRS cells of CHL patients was not significantly associated with clinical outcomes. Further studies with larger patient populations and extended follow-up periods are required to validate these findings.

Keywords: CD20; Hodgkin Reed-Sternberg cells; classical Hodgkin lymphoma; immunophenotype.