- Design
- Case-cohort biomarker study within the EORTC-GELA H9 randomised trial
- Population
- 257 patients with early-stage classic Hodgkin lymphoma, 105 progression events
- Primary outcome
- Progression-free survival by c-MET, HLA class II and CD68 status
- Effect
- HR 0.75 (0.46-1.24), 0.85 (0.50-1.45) and 0.86 (0.52-1.44)
A case-cohort analysis of the EORTC-GELA H9 trial (PLOS ONE, 8 October 2026) tested immunohistochemistry for c-MET, HLA class II and CD68 in diagnostic tissue from 257 patients with early-stage classic Hodgkin lymphoma, with 105 progression events.
c-MET was expressed by tumour cells in 67% and cell-surface HLA class II in 51%. None of the three markers was associated with progression-free survival: hazard ratios 0.75 (95% CI 0.46-1.24) for c-MET, 0.85 (0.50-1.45) for HLA class II and 0.86 (0.52-1.44) for high CD68. Because none was significant alone, combinations were not analysed.
CD68 and macrophage counts in particular have long featured in Hodgkin prognostic discussions. This result, from trial material with a rigorous design, argues against adding them to routine reports for prognosis in early-stage disease. The authors note that risk-adapted treatment within the trial and scoring difficulty may have blunted any effect, and advanced-stage disease was not studied.
- Do not report c-MET, HLA class II or CD68 as prognostic markers in early-stage classic Hodgkin lymphoma
- Keep the diagnostic panel focused on confirming the diagnosis and excluding mimics
- Treat prognostic biomarker claims in Hodgkin lymphoma as unvalidated until tested in trial cohorts
- Note that this did not test advanced-stage disease
Why it matters
Stains often added to Hodgkin workups for prognosis did not hold up in trial material.
Don't overread it
Applies to early-stage disease treated within a risk-adapted trial; advanced stage was not studied.
The statistics, in plain English
All three hazard ratios have confidence intervals crossing 1.0, so no detectable association with progression. The intervals are fairly wide (roughly halving to a 45% rise in risk), so a modest effect cannot be ruled out, but nothing large enough to guide treatment.
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