Tumour-associated macrophages have been linked with a poor outcome in patients with Hodgkin lymphoma. In a multicentre phase III trial of 287 patients randomized to a training cohort and validation cohort, increased expression levels of CD68 and CD163 were significantly associated with worse failure-free and overall survival outcomes in the validation cohort. Analysis of the validation cohort showed both markers were independent predictors of inferior survival outcomes, and thus have prognostic significance.