Hodgkin's disease (HD) is a peculiar type of human malignant lymphoma
characterized by a very low frequency of tumor cells, the so called Ho
dgkin and Reed-Sternberg (H-RS) cells, embedded in a hyperplastic back
ground of non-neoplastic (reactive) cells recruited and activated by H
-RS cells-derived cytokines. H-RS cells can be functionally regarded a
s antigen-presenting cells (APC) able to elicit an intense, but anergi
c and ineffective, T-cell mediated immune response along with a hyperp
lastic inflammatory reaction which involves several cell types includi
ng T-and B-cells, neutrophils, eosinophils, plasma cells, fibroblasts
and stromal cells. In tissues involved by HD, malignant H-RS cells and
their reactive neighboring cells are able to cross-talk via a complex
network of cytokine- and cell contact-dependent interactions. As a re
sult of such interactions, mediated by specific surface receptors and
adhesion molecules on both tumor and non-neoplastic cells, H-RS cells
may receive several proliferative and anti-apoptotic signals favoring
the cellular expansion and tumor cell survival in HD. The ineffective
T-cell immune response elicited by the abnormal APC function of H-RS c
ells may further contribute to the biologic and clinical progression o
f HD. Innovative therapeutic strategies aimed at blocking the pathways
of dysregulated cellular cross-talk among H-RS cells and bystander re
active cell populations might be beneficial in the teatment of HD pati
ents.