Distinct cell state ecosystems for nodular lymphocyte-predominant Hodgkin lymphoma

A Ajay Subramanian S Shengqin Su J Jamie Flerlage S Stefan Alig S Sheren Younes L Lianna J. Marks C Chelsea Pinnix F Francisco Vega R Raphael Steiner P Priya Kumar H Heidi Mocikova A Alice Sykorova V Vit Prochazka C Cristiane Milito P Pamela Allen D Darina Paulino A Alan Ramsay T Timothy Flerlage M Monica Palese R Robert West C ChunFang Zhu T Troy Noordenbos J Joseph Schroers-Martin S Shuchun Zhao N Natalie J. Park A Anusha Kalbasi E Everett J. Moding A Aaron M. Newman R Ranjana H. Advani R Richard T. Hoppe M Maximilian Diehn Y Yasodha Natkunam A Ash A. Alizadeh M Michael Sargent Binkley

Abstract

Abstract Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare cancer, and few studies have comprehensively investigated the immune microenvironment and rare lymphocyte-predominant (LP) cells. Here we develop a NLPHL specific lymphocyte-predominant ecotype (LPE) model to identify 34 distinct cell states across 14 cell types that co-occur within 3 LPEs for 171 cases. LPE1 and LPE2 were characterized by immunosuppressive microenvironments with high expression of B2M on LP cells, CD8 T-cell exhaustion, immune checkpoint genes expressed by follicular T-cells, and an improved freedom from progression compared to LPE3 in training (n = 109, with 65% LPE1/2) and validation cohorts (n = 62, with 61% LPE1/2). We validate the co-occurrence and co-localization of cell states using spatial transcriptomics. Protein expression of HLA-I and HLA-II on LP cells and SSTR2 on dendritic cells was predictive of LPE1 (C-statistic=0.69), LPE2 (C-statistic=0.79), and LPE3 (C-statistic=0.60). This study establishes a clinically relevant biologic categorization for NLPHL.

Article Details

Volume / Issue Vol. 16, Issue 1
Published September 26, 2025
ISSN 2041-1723
Publisher Nature Portfolio

Journal Info

Nature Communications

Nature Portfolio

ISSN: 2041-1723 Open Access Life Sciences

Authors (34)

A

Ajay Subramanian

S

Shengqin Su

J

Jamie Flerlage

S

Stefan Alig

S

Sheren Younes

L

Lianna J. Marks

C

Chelsea Pinnix

F

Francisco Vega

R

Raphael Steiner

P

Priya Kumar

H

Heidi Mocikova

A

Alice Sykorova

V

Vit Prochazka

C

Cristiane Milito

P

Pamela Allen

D

Darina Paulino

A

Alan Ramsay

T

Timothy Flerlage

M

Monica Palese

R

Robert West

C

ChunFang Zhu

T

Troy Noordenbos

J

Joseph Schroers-Martin

S

Shuchun Zhao

N

Natalie J. Park

A

Anusha Kalbasi

E

Everett J. Moding

A

Aaron M. Newman

R

Ranjana H. Advani

R

Richard T. Hoppe

M

Maximilian Diehn

Y

Yasodha Natkunam

A

Ash A. Alizadeh

M

Michael Sargent Binkley