{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T22:14:58Z","timestamp":1791152098591,"version":"4.1.0"},"reference-count":25,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"16","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2005,6,1]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p> Although most classical Hodgkin's lymphoma (CHL) patients are cured, a significant minority fails primary therapy and may die as a result of their disease. Age, stage, and other basic clinical and laboratory parameters, which comprise the International Prognostic Score (IPS), are used at diagnosis to predict outcome. To date, there is no consensus on biologic markers that add value to these parameters. <\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p> We evaluated 107 CHL patients for bcl-2, p53, and p21 expression by immunohistochemistry using tissue microarrays and correlated the results with outcome. The median follow-up of the 79 surviving patients was 6.8 years. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Univariate analysis showed that age \u2265 45 years, stage III or IV, and IPS \u2265 3 were associated with a poor failure-free survival (FFS) and overall survival (OS). bcl-2 was expressed in 26% of patients and was associated with poor FFS and a trend for OS. p53 expression in combination with lack of p21 expression was not associated with outcome. Multivariate analysis showed that three factors were independently associated with both FFS and OS: age \u2265 45 years, stage III or IV, and bcl-2 expression. Using these three parameters, a scoring system was devised that stratified patients into three risk groups (with zero, one, or two to three of these risk factors) and a progressively worse FFS and OS (P &lt; .001). <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> Expression of bcl-2 in CHL is a useful, independent prognostic marker and can be used in association with clinical parameters to identify newly diagnosed patients with a good, intermediate, or poor prognosis. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.2005.04.358","type":"journal-article","created":{"date-parts":[[2005,4,5]],"date-time":"2005-04-05T00:31:05Z","timestamp":1112661065000},"page":"3773-3779","source":"Crossref","is-referenced-by-count":52,"title":["Expression of bcl-2 in Classical Hodgkin's Lymphoma: An Independent Predictor of Poor Outcome"],"prefix":"10.1200","volume":"23","author":[{"given":"Stephen J.","family":"Sup","sequence":"first","affiliation":[{"name":"From the Department of Clinical Pathology, and Department of Hematology and Medical Oncology, Cleveland Clinic Foundation, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos A.","family":"Alema\u00f1y","sequence":"additional","affiliation":[{"name":"From the Department of Clinical Pathology, and Department of Hematology and Medical Oncology, Cleveland Clinic Foundation, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brad","family":"Pohlman","sequence":"additional","affiliation":[{"name":"From the Department of Clinical Pathology, and Department of Hematology and Medical Oncology, Cleveland Clinic Foundation, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Elson","sequence":"additional","affiliation":[{"name":"From the Department of Clinical Pathology, and Department of Hematology and Medical Oncology, Cleveland Clinic Foundation, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serena","family":"Malhi","sequence":"additional","affiliation":[{"name":"From the Department of Clinical Pathology, and Department of Hematology and Medical Oncology, Cleveland Clinic Foundation, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Snehal","family":"Thakkar","sequence":"additional","affiliation":[{"name":"From the Department of Clinical Pathology, and Department of Hematology and Medical Oncology, Cleveland Clinic Foundation, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roxanne","family":"Steinle","sequence":"additional","affiliation":[{"name":"From the Department of Clinical Pathology, and Department of Hematology and Medical Oncology, Cleveland Clinic Foundation, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric D.","family":"Hsi","sequence":"additional","affiliation":[{"name":"From the Department of Clinical Pathology, and Department of Hematology and Medical Oncology, Cleveland Clinic Foundation, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1008325627670"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199811193392104"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1016\/S0046-8177(97)90077-0"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1097\/00129039-200309000-00002"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V100.12.3935"},{"key":"R6","unstructured":"Smolewski P, Niewiadomska H, Blonski JZ, et al: Expression of proliferating cell nuclear antigen (PCNA) and p53, bcl-2 or C-erb B-2 proteins on Reed-Sternberg cells: Prognostic significance in Hodgkin's disease. 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