IMMUNOLOGICAL STATUS AND PROGNOSIS IN HODGKIN'S LYMPHOMA: THERAPEUTIC IMPLICATIONS AND CLINICAL EVOLUTION

Abstract

Introduction: Hodgkin Lymphoma is a rare malignant neoplasm, characterized by Hodgkin and Reed-Sternberg cells, whose clinical evolution depends on the interactions within the tumor microenvironment. Despite high cure rates, refractory and relapsed cases still represent a challenge, with immunological factors affecting the treatment response. Objective: To evaluate the relationship between the immunological profile of patients and the disease prognosis, investigating how the immunological status can influence treatment response and clinical evolution. Methodology: This is an integrative review carried out between February and November 2025, using DeCS descriptors in databases such as Scielo and PubMed, selecting studies published in the last five years that addressed immunological biomarkers in HL. Results: A total of 6,332 studies were identified. After applying the inclusion and exclusion criteria, 12 articles were selected. The development and progression of HL depend on a complex network of cellular interactions in the tumor microenvironment, which supports immune evasion. Immunological imbalance and the predominance of immunosuppressive elements are associated with worse outcomes, while certain cellular profiles may indicate better therapeutic response. High levels of macrophages and PD-L1 correlate with an unfavorable prognosis, while the presence of regulatory T cells and auxiliary CD4+ T cells has been linked to a better prognosis. Conclusions: Understanding the immunological profile is essential for refining the prognosis and personalizing treatments. Although there are significant advances, new studies are needed to identify more precise biomarkers and integrate this information into clinical protocols, contributing to more effective and individualized therapeutic strategies.