CD163 Immunohistochemistry Is Superior to CD68 in Predicting Outcome in Classical Hodgkin Lymphoma

Jonathan L. Klein, Tu Dung T. Nguyen, Gabriel A. Bien-Willner, Ling Chen, Kelley V. Foyil, Nancy L. Bartlett, Eric J. Duncavage, Anjum Hassan, John L. Frater, Friederike Kreisel

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48 Scopus citations


Objectives: In recent years, research has increasingly focused on the microenvironment of classical Hodgkin lymphoma (CHL) as a predictor of treatment outcome. The focus of this study was to assess the interobserver reproducibility in interpreting macrophage-associated immunohistochemistry (IHC) for CD68 and CD163 in a retrospective cohort of 88 patients with CHL. Methods: Staining results were correlated with clinical outcome in all patients and those with a high international prognostic score (IPS). Results: The intraclass correlation (ICC) for the five hematopathologists interpreting the IHC was stronger for CD163 (0.70) than for CD68 (0.50). Using a cutoff of 25% mean macrophage reactivity and including all patients, a statistically significant difference in overall survival (OS) was seen only for CD163 ( P = .0006) and not for CD68 ( P = .414). Patients with a mean CD163 reactivity of 25% or more had a median OS of 71 months vs 101 months for patients with less than 25% reactivity. CD163 retained statistical significance in multivariate analysis. In patients with advanced-stage CHL with high IPS, OS was also significantly worse for those with a mean CD163 reactivity of 25% or higher. Conclusions: Our study confirms previous reports of a prognostic role of tumor-infiltrating macrophages in CHL, but only for CD163. Although most of the literature supports an increasing role of macrophage IHC as a predictor of clinical outcome, successful clinical translation will require a standardized method and reporting system.

Original languageEnglish
Pages (from-to)381-387
Number of pages7
JournalAmerican journal of clinical pathology
Issue number3
StatePublished - Mar 1 2014


  • CD163
  • CD68
  • Classical hodgkin lymphoma
  • High ips
  • Overall survival
  • Tumor-infiltrating macrophages


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