The Role of Myeloid-Derived Suppressor Cells in the Immunopathogenesis of Hodgkin Lymphoma: Integrative Literature Review

Abstract

Introduction: Hodgkin lymphoma (HL) is a hematological malignancy characterized by Hodgkin and Reed-Sternberg cells embedded in a tumor microenvironment rich in inflammatory mediators and immune cells, which plays a central role in disease progression and immune evasion. Among these components, myeloid-derived suppressor cells (MDSCs) have emerged as key regulators of antitumor immunity. Objective: To review and synthesize current evidence on the role of MDSCs in the immunopathogenesis of HL, emphasizing their phenotypic subtypes, mechanisms of action, and clinical relevance. Method: This study consists of a literature review based on the critical analysis of experimental and clinical studies retrieved from national and international databases. Eligible studies addressed the interaction between MDSCs, tumor cells, and the tumor microenvironment in HL. Results: The analyzed studies indicate that MDSCs are increased in patients with HL and are associated with poor prognosis, higher tumor burden, and reduced response to conventional therapies. MDSCs exert immunosuppressive effects through the production of arginase, nitric oxide, reactive oxygen species, and anti-inflammatory cytokines, while promoting regulatory T-cell expansion and inhibiting cytotoxic T lymphocyte and natural killer cell activity. In addition, MDSCs interact with other myeloid populations within the tumor microenvironment, further amplifying immune evasion mechanisms. Conclusion: Overall, the evidence supports a central role for MDSCs in the immunopathogenesis of HL, influencing tumor microenvironment dynamics and therapeutic response. Improved understanding of these interactions may support the development of novel immunomodulatory strategies and the identification of prognostic and predictive biomarkers in HL.