Why a lymphopenia in patients with lymphoma can be found, pathophysiology of Morbus Hodgkin

A lymphopenia is a common finding in patients with Morbus Hodgkin. At the earlier stage of disease just 25% of the patients show a lymphopenia. However, as the disease progresses, a lymphopenia can be found in most patients.

The reasons for developing a lymphopenia remain unclear but some mechanism are discussed:

- The tumor cell expresses immune inhibitory molecules (f.i. PD-1-lingand). This results in a disorder of lymphocytosis as the differentation process of progenitor cells is impaired.

- The tumor cell produces cytokines as TGF (transforming growth factor) which can suppress lymphocytes.

- Chronically activated lymphocates within the tumor result in an upregulation of death receptors. This could result in an apoptosis of the lymphocytes.

Source:  Tamar Tadmor & Aaron Polliack (2010) Lymphopenia a simple prognostic factor in lymphoma and other cancers: why not use it more as a guide?, Leukemia & Lymphoma, 51:10, 1773-1774, DOI: 10.3109/10428194.2010.508825