Does CD47 expression have prognostic significance in classical Hodgkin lymphoma?

Background/aim: Hodgkin lymphoma (HL) is highly treatable, but new chemotherapy agents are needed for patients with progression or recurrence. CD47 regulates antiphagocytic activity by signaling through the signal regulatory protein alpha (SIRPα) pathway on macrophages. This study aimed to assess the expression of CD47 in HL cases and explore its relationship with Epstein-Barr virus (EBV) status and the International Prognostic Index (IPI). Materials and methods: One hundred twenty patients diagnosed with classical HL, characterized by the presence of Hodgkin and Reed-Sternberg (HRS) cells, and for whom IPI scores were available were included. Their demographic data and EBV status were retrieved from hospital records. CD47 immunohistochemical expression in HRS cells was evaluated based on its prevalence and intensity. The product of these two values was used to calculate the CD47 expression score. Results: Of the 120 patients, 76 (63.33%) were male and 44 (36.66%) were female, with an average age of 38.77 years. EBV ISH test results were available for 93 patients, of which 48 (51.61%) were positive. CD47 expression was 67% on average, and patients were categorized based on CD47 expression scores of ≤6 and >6 and IPI scores of ≤2 and >2. No significant relationship was found between CD47 expression score and age (p: 0.990), sex (p: 0.086), EBV status (p: 0.374), or IPI score (p: 0.805). However, higher IPI scores were significantly associated with increased EBV positivity (p: 0.041). Conclusion: CD47 was widely expressed, but no significant relationship with clinical parameters was observed. Further studies are required to validate its role as a biomarker.