AUTHOR=Jimenez Oscar , Mangiaterra Tamara , Colli Sandra , GarcĂ­a Lombardi Mercedes , Preciado Maria Victoria , De Matteo Elena , Chabay Paola TITLE=PD-1 and LAG-3 expression in EBV-associated pediatric Hodgkin lymphoma has influence on survival JOURNAL=Frontiers in Oncology VOLUME=Volume 12 - 2022 YEAR=2022 URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.957208 DOI=10.3389/fonc.2022.957208 ISSN=2234-943X ABSTRACT=In pediatric Hodgkin lymphoma (HL), the inability of the cytotoxic microenvironment induced by EBV presence to eliminate tumor cells could reflect that the virus might be able to induce the expression of exhaustion markers to evade immune response. Therefore, the expression of exhaustion markers in pediatric EBV-associated HL was evaluated. A balance between cytotoxic GrB and Th1 Tbet markers with regulatory Foxp3 was proved in EBV+ cases. In addition, exclusively in EBV- associated cHL a correlation between PD-1 and LAG-3 expression was observed. Furthermore, also those cases displayed a trend to a worse survival when they expressed LAG-3, and an inferior event free survival when both PD-1 and LAG-3 molecules were present. Therefore, even though a cytotoxic and inflammatory environment was supposed to be triggered by EBV presence in pediatric cHL, it seems that the virus may also induce the synergic effect of inhibitory molecules LAG-3 and PD-1 in this series. These observations may reflect that the permissive and exhausted immune microenvironment succeed to induce lymphomagenesis.