51
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Ilcus C, Bagacean C, Tempescul A, Popescu C, Parvu A, Cenariu M, Bocsan C, Zdrenghea M. Immune checkpoint blockade: the role of PD-1-PD-L axis in lymphoid malignancies. Onco Targets Ther 2017; 10:2349-2363. [PMID: 28496333 PMCID: PMC5417656 DOI: 10.2147/ott.s133385] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The co-inhibitory receptor programmed cell death (PD)-1, expressed by immune effector cells, is credited with a protective role for normal tissue during immune responses, by limiting the extent of effector activation. Its presently known ligands, programmed death ligands (PD-Ls) 1 and 2, are expressed by a variety of cells including cancer cells, suggesting a role for these molecules as an immune evasion mechanism. Blocking of the PD-1-PD-L signaling axis has recently been shown to be effective and was clinically approved in relapsed/refractory tumors such as malignant melanoma and lung cancer, but also classical Hodgkin’s lymphoma. A plethora of trials exploring PD-1 blockade in cancer are ongoing. Here, we review the role of PD-1 signaling in lymphoid malignancies, and the latest results of trials investigating PD-1 or PD-L1 blocking agents in this group of diseases. Early phase studies proved very promising, leading to the clinical approval of a PD-1 blocking agent in Hodgkin’s lymphoma, and Phase III clinical studies are either planned or ongoing in most lymphoid malignancies.
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Affiliation(s)
- Cristina Ilcus
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cristina Bagacean
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Laboratory of Immunology and Immunotherapy, Brest University Medical School, CHRU Morvan
| | - Adrian Tempescul
- Department of Clinical Hematology, Institute of Cancerology and Hematology, Brest, France
| | - Cristian Popescu
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Andrada Parvu
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Hematology, Ion Chiricuta Oncology Institute
| | - Mihai Cenariu
- Biotechnology Research Center, University of Agricultural Sciences and Veterinary Medicine
| | - Corina Bocsan
- Department of Clinical Pharmacology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mihnea Zdrenghea
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Hematology, Ion Chiricuta Oncology Institute
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52
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Stevens WBC, Mendeville M, Redd R, Clear AJ, Bladergroen R, Calaminici M, Rosenwald A, Hoster E, Hiddemann W, Gaulard P, Xerri L, Salles G, Klapper W, Pfreundschuh M, Jack A, Gascoyne RD, Natkunam Y, Advani R, Kimby E, Sander B, Sehn LH, Hagenbeek A, Raemaekers J, Gribben J, Kersten MJ, Ylstra B, Weller E, de Jong D. Prognostic relevance of CD163 and CD8 combined with EZH2 and gain of chromosome 18 in follicular lymphoma: a study by the Lunenburg Lymphoma Biomarker Consortium. Haematologica 2017; 102:1413-1423. [PMID: 28411252 PMCID: PMC6643731 DOI: 10.3324/haematol.2017.165415] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 04/11/2017] [Indexed: 01/25/2023] Open
Abstract
In follicular lymphoma, studies addressing the prognostic value of microenvironment-related immunohistochemical markers and tumor cell-related genetic markers have yielded conflicting results, precluding implementation in practice. Therefore, the Lunenburg Lymphoma Biomarker Consortium performed a validation study evaluating published markers. To maximize sensitivity, an end of spectrum design was applied for 122 uniformly immunochemotherapy-treated follicular lymphoma patients retrieved from international trials and registries. The criteria were: early failure, progression or lymphoma-related death <2 years versus long remission, response duration of >5 years. Immunohistochemical staining for T cells and macrophages was performed on tissue microarrays from initial biopsies and scored with a validated computer-assisted protocol. Shallow whole-genome and deep targeted sequencing was performed on the same samples. The 96/122 cases with complete molecular and immunohistochemical data were included in the analysis. EZH2 wild-type (P=0.006), gain of chromosome 18 (P=0.002), low percentages of CD8+ cells (P=0.011) and CD163+ areas (P=0.038) were associated with early failure. No significant differences in other markers were observed, thereby refuting previous claims of their prognostic significance. Using an optimized study design, this Lunenburg Lymphoma Biomarker Consortium study substantiates wild-type EZH2 status, gain of chromosome 18, low percentages of CD8+ cells and CD163+ area as predictors of early failure to immunochemotherapy in follicular lymphoma treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP [-like]), while refuting the prognostic impact of various other markers.
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Affiliation(s)
| | - Matias Mendeville
- Department of Pathology, VU University Medical Center, Amsterdam, the Netherlands
| | - Robert Redd
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Andrew J Clear
- Centre for Haemato-Oncology, Barts Cancer Institute, University of London, UK
| | - Reno Bladergroen
- Department of Pathology, VU University Medical Center, Amsterdam, the Netherlands
| | - Maria Calaminici
- Centre for Haemato-Oncology, Barts Cancer Institute, University of London, UK
| | - Andreas Rosenwald
- Institute of Pathology, Comprehensive Cancer Center Mainfranken, University of Würzburg, Germany
| | - Eva Hoster
- Department of Medicine III, University Hospital Grosshadern, Munich, Germany
| | - Wolfgang Hiddemann
- Department of Medicine III, University Hospital Grosshadern, Munich, Germany
| | - Philippe Gaulard
- Department of Pathology and Inserm U955, Hôpital Henri Mondor, University Paris-Est, Créteil, France
| | - Luc Xerri
- Département de Biopathologie, Institut Paoli-Calmettes, Marseille, France
| | - Gilles Salles
- Service d'Hématologie,Hospices Civils de Lyon & Université Claude Bernard Lyon-1, UMR CNRS 5239, France
| | - Wolfram Klapper
- Institute of Pathology, University of Schleswig-Holstein, Kiel, Germany
| | | | - Andrew Jack
- Haematological Malignancy Diagnostic Service, St James's University Hospital, Leeds, UK
| | - Randy D Gascoyne
- Department of Pathology & Medical Oncology, Centre for Lymphoid Cancer, British Columbia Cancer Agency, University of British Columbia, Vancouver, Canada
| | - Yasodha Natkunam
- Department of Pathology, Stanford University School of Medicine, CA, USA
| | - Ranjana Advani
- Department of Hematology, Stanford University School of Medicine, CA, USA
| | - Eva Kimby
- Department of Medicine, Division of Hematology, Karolinska Institute, Stockholm, Sweden
| | - Birgitta Sander
- Department of Laboratory Medicine, Division of Pathology, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden
| | - Laurie H Sehn
- Department of Pathology & Medical Oncology, Centre for Lymphoid Cancer, British Columbia Cancer Agency, University of British Columbia, Vancouver, Canada
| | - Anton Hagenbeek
- Department of Hematology, Academic Medical Center, Amsterdam, the Netherlands
| | - John Raemaekers
- Department of Hematology, Radboudumc, Nijmegen, the Netherlands
| | - John Gribben
- Centre for Haemato-Oncology, Barts Cancer Institute, University of London, UK
| | - Marie José Kersten
- Department of Hematology, Academic Medical Center, Amsterdam, the Netherlands
| | - Bauke Ylstra
- Department of Pathology, VU University Medical Center, Amsterdam, the Netherlands
| | - Edie Weller
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Daphne de Jong
- Department of Pathology, VU University Medical Center, Amsterdam, the Netherlands
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53
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Xerri L, Huet S, Venstrom JM, Szafer-Glusman E, Fabiani B, Canioni D, Chassagne-Clément C, Dartigues-Cuilléres P, Charlotte F, Laurent C, Gelas-Dore B, Bolen CR, Punnoose E, Bouabdallah R, Brice P, Morschhauser F, Cartron G, Olive D, Salles G. Rituximab treatment circumvents the prognostic impact of tumor-infiltrating T-cells in follicular lymphoma patients. Hum Pathol 2017; 64:128-136. [PMID: 28414090 DOI: 10.1016/j.humpath.2017.03.023] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 03/13/2017] [Accepted: 03/26/2017] [Indexed: 01/10/2023]
Abstract
Previous immunohistochemical (IHC) studies showed controversial data about the prognostic value of tumor-infiltrating lymphocytes (TILs) in follicular lymphoma (FL). To clarify this issue, a large series of FL samples from rituximab-treated patients enrolled in the randomized PRIMA trial was examined. IHC was quantified using automated image analysis in 417, 287, 418, 406, 379, and 369 patients for CD3, CD4, CD8, PD1, ICOS, and FOXP3, respectively. RNAseq analysis was used to quantify TIL-related mRNA transcripts from 148 patients. When each IHC marker was used as a continuous variable in the whole cohort, high CD3 counts were associated with better progression-free survival (PFS) (P = .025). When an optimal IHC cut point was applied to the whole patient population, high CD3 counts and high PD1 counts were associated with better PFS (P = .011 and P = .044, respectively), whereas none of the other TIL markers had any significant correlation with outcome. When a stringent analysis was performed by dividing the whole cohort into a training set and a validation set, none of the TIL markers showed a prognostic significance in both groups. RNAseq analysis showed a significant correlation between high levels of CD3 and CD8 transcripts and better PFS (P = .001 and P = .037, respectively). No prognostic correlation was found as to the level of other immune gene transcripts. These results suggest that the IHC prognostic value of TILs is circumvented by rituximab treatment, although there is a trend for high numbers of CD3+ TILs to correlate with better PFS.
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Affiliation(s)
- Luc Xerri
- Department of Bio-Pathology, Hematology, and Tumor Immunology, Institut Paoli-Calmettes and Aix-Marseille Univ, Marseille, France; Centre de Recherche en Cancérologie de Marseille (CRCM), Inserm, U1068, Marseille, F-13009, France; CNRS, UMR7258, Marseille, F-13009, Institut Paoli-Calmettes, Marseille, F-13009, France; Aix-Marseille University, UM, 105, F-13284, Marseille, France.
| | - Sarah Huet
- INSERM1052, CNRS 5286, Centre de Recherche en Cancerologie de Lyon, Faculté de Médecine Lyon-Sud Charles Mérieux, Hospices Civils De Lyon, Laboratoire d'hématologie, F-69495 Pierre Bénite cedex
| | | | | | - Bettina Fabiani
- Department of Pathology, Centre Hospitalier Saint Antoine, F-75571 Paris, France
| | - Danielle Canioni
- Department of Pathology, Centre Hospitalier Necker, F-75743 Paris, France
| | | | | | - Fréderic Charlotte
- Department of Pathology, Centre Hospitalier Pitié-Salpêtriére, F-75651 France
| | - Camille Laurent
- Department of Pathology, INSERM U.1037, Institut Universitaire du Cancer-Oncopole, F-31059 Toulouse
| | - Benedicte Gelas-Dore
- INSERM1052, CNRS 5286, Centre de Recherche en Cancerologie de Lyon, Faculté de Médecine Lyon-Sud Charles Mérieux, Hospices Civils De Lyon, Laboratoire d'hématologie, F-69495 Pierre Bénite cedex
| | | | | | - Reda Bouabdallah
- Department of Bio-Pathology, Hematology, and Tumor Immunology, Institut Paoli-Calmettes and Aix-Marseille Univ, Marseille, France; Centre de Recherche en Cancérologie de Marseille (CRCM), Inserm, U1068, Marseille, F-13009, France; CNRS, UMR7258, Marseille, F-13009, Institut Paoli-Calmettes, Marseille, F-13009, France; Aix-Marseille University, UM, 105, F-13284, Marseille, France
| | - Pauline Brice
- Department of Hematology, Centre Hospitalier Saint Louis, F-75475 Paris, France
| | - Franck Morschhauser
- Department of Hematology, Hopital Claude Huriez, Unité GRITA, Université de Lille 2, F-59000 Lille, France
| | - Guillaume Cartron
- Departement of Hematology, CHU Montpellier, UMR CNRS-5235, F-34295 Montpellier, France
| | - Daniel Olive
- Department of Bio-Pathology, Hematology, and Tumor Immunology, Institut Paoli-Calmettes and Aix-Marseille Univ, Marseille, France; Centre de Recherche en Cancérologie de Marseille (CRCM), Inserm, U1068, Marseille, F-13009, France; CNRS, UMR7258, Marseille, F-13009, Institut Paoli-Calmettes, Marseille, F-13009, France; Aix-Marseille University, UM, 105, F-13284, Marseille, France
| | - Gilles Salles
- INSERM1052, CNRS 5286, Centre de Recherche en Cancerologie de Lyon, Faculté de Médecine Lyon-Sud Charles Mérieux, Hospices Civils De Lyon, Laboratoire d'hématologie, F-69495 Pierre Bénite cedex
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54
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Ma B, Ujjani C. The clinical development of obinutuzumab for the treatment of follicular lymphoma. Cancer Manag Res 2017; 9:103-113. [PMID: 28435325 PMCID: PMC5391868 DOI: 10.2147/cmar.s114526] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Impressive progress has been made in recent decades for advanced-stage follicular lymphoma with the availability of anti-CD20 monoclonal antibodies, initially rituximab and more recently obinutuzumab. Obinutuzumab is a unique, third-generation, fully humanized glycoengineered IgG1 type II anti-CD20 monoclonal antibody. It has been shown to have increased antitumor activity compared to rituximab in preclinical studies, including whole-blood B-cell depletion assays, xenograft models, and primate models. This has spurred on the development of obinutuzumab through Phase I/II trials as monotherapy and in combination with chemotherapeutic agents and other targeted therapies. Its efficacy compared to rituximab and in rituximab-refractory disease has led to its continued development and eventual approval for the treatment of follicular lymphoma. Here in this review, we highlight the design and development of obinutuzumab in the treatment of advanced stage grade 1-3A follicular lymphoma and its future directions.
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Affiliation(s)
| | - Chaitra Ujjani
- Lombardi Comprehensive Cancer Center, MedStar Georgetown University Hospital, Washington, DC, USA
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55
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Sugimoto T, Watanabe T. Follicular Lymphoma: The Role of the Tumor Microenvironment in Prognosis. J Clin Exp Hematop 2017; 56:1-19. [PMID: 27334853 DOI: 10.3960/jslrt.56.1] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
The microenvironment of follicular lymphoma (FL) is composed of tumor-infiltrating CD8(+) T cells, follicular regulatory T cells, lymphoma-associated macrophages and mast cells, follicular helper T cells, follicular dendritic cells, and follicular reticular cells, all of which have been reported to have relevance in the prognosis of FL patients. In addition, some of these cells play a role in the histologic transformation of FL. Macrophages contribute to a poor prognosis in FL patients treated in the pre-rituximab era, but are associated with good prognosis in those treated in the rituximab era. T-cell immunoglobulin and mucin domain protein (TIM) 3 are markers of T-cell exhaustion, and T cells co-expressing programed death 1 (PD1) in peripheral blood and lymph nodes secrete interleukin (IL)-12 in the serum. Serum CXCL9, IL-2 receptor, and IL-1 receptor agonist are associated with shorter survival of FL patients. Agents for manipulation of the microenvironment surrounding FL cells include the immunomodulatory drug lenalidomide, immune check-point inhibitors, and cyclophosphamide prior to rituximab. To battle FL and to improve the outcomes of FL patients, understanding the relationship between neoplastic cells and the various microenvironmental cellular components is crucial for developing therapeutics against the microenvironment.
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56
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Kim Y, Won C, Chang S, Lee M, Choi J, Lee W. Expression of programmed death-1 in cutaneous extranodal natural killer/T-cell lymphoma and its effect on clinical findings and biological behaviour. J Eur Acad Dermatol Venereol 2017; 31:821-827. [DOI: 10.1111/jdv.14165] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 01/23/2017] [Indexed: 12/22/2022]
Affiliation(s)
- Y.J. Kim
- Department of Dermatology; Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
| | - C.H. Won
- Department of Dermatology; Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
| | - S.E. Chang
- Department of Dermatology; Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
| | - M.W. Lee
- Department of Dermatology; Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
| | - J.H. Choi
- Department of Dermatology; Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
| | - W.J. Lee
- Department of Dermatology; Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
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57
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Senaras C, Pennell M, Chen W, Sahiner B, Shana'ah A, Louissaint A, Hasserjian R, Lozanski G, Gurcan MN. FOXP3-stained image analysis for follicular lymphoma: Optimal adaptive thresholding with maximal nucleus coverage. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2017; 10140:101400E. [PMID: 28579665 PMCID: PMC5452684 DOI: 10.1117/12.2255671] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Immunohistochemical detection of FOXP3 antigen is a usable marker for detection of regulatory T lymphocytes (TR) in formalin fixed and paraffin embedded sections of different types of tumor tissue. TR plays a major role in homeostasis of normal immune systems where they prevent auto reactivity of the immune system towards the host. This beneficial effect of TR is frequently "hijacked" by malignant cells where tumor-infiltrating regulatory T cells are recruited by the malignant nuclei to inhibit the beneficial immune response of the host against the tumor cells. In the majority of human solid tumors, an increased number of tumor-infiltrating FOXP3 positive TR is associated with worse outcome. However, in follicular lymphoma (FL) the impact of the number and distribution of TR on the outcome still remains controversial. In this study, we present a novel method to detect and enumerate nuclei from FOXP3 stained images of FL biopsies. The proposed method defines a new adaptive thresholding procedure, namely the optimal adaptive thresholding (OAT) method, which aims to minimize under-segmented and over-segmented nuclei for coarse segmentation. Next, we integrate a parameter free elliptical arc and line segment detector (ELSD) as additional information to refine segmentation results and to split most of the merged nuclei. Finally, we utilize a state-of-the-art super-pixel method, Simple Linear Iterative Clustering (SLIC) to split the rest of the merged nuclei. Our dataset consists of 13 region-of-interest images containing 769 negative and 88 positive nuclei. Three expert pathologists evaluated the method and reported sensitivity values in detecting negative and positive nuclei ranging from 83-100% and 90-95%, and precision values of 98-100% and 99-100%, respectively. The proposed solution can be used to investigate the impact of FOXP3 positive nuclei on the outcome and prognosis in FL.
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Affiliation(s)
- C. Senaras
- Department of Biomedical Informatics, The Ohio State University
| | - M. Pennell
- Division of Biostatistics, College of Public Health, The Ohio State University
| | - W. Chen
- Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, Food and Drug Administration, S
| | - B. Sahiner
- Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, Food and Drug Administration, S
| | - A. Shana'ah
- Department of Pathology, The Ohio State University
| | - A. Louissaint
- Department of Pathology Massachusetts General Hospital
| | | | - G. Lozanski
- Department of Pathology, The Ohio State University
| | - M. N. Gurcan
- Department of Biomedical Informatics, The Ohio State University
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58
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Burroni B, Broudin C, Damotte D, Laurent C. [Immune-checkpoint and hemopathies]. Ann Pathol 2017; 37:101-110. [PMID: 28161001 DOI: 10.1016/j.annpat.2016.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 12/06/2016] [Indexed: 11/26/2022]
Abstract
Immune-checkpoint inhibitors represent potent new therapies for most lymphomas, particularly for refractory diseases. Contrasting with solid tumors the majority of lymphoma are sensitive to conventional therapies and immunotherapies such as anti-CD20 or anti-CD30. But relapsing lymphoma or refractory disease have a very poor prognosis and new drugs are mandatory. Immune-checkpoint inhibitors targeting CTLA4, PD-1 et PD-L1 demonstrated efficiency with prolonged survivals even after bone marrow allograft for aggressive disease. Lymphomas differ from solid tumors as tumor cells belong to the immune compartment and therefore molecules targeting immune cells may act on both immune environment and tumor cells. Furthermore, PD-L1 expression in most lymphomas is related to tumor cell molecular alterations such as PD-L1 gene amplification or mutation. PD-L1 protein expression on tumor cells and immune cells, particularly it frequency and distribution vary according to different lymphoma subtype and it may help to assess diagnosis as it may predict therapeutical response.
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Affiliation(s)
- Barbara Burroni
- Service de pathologie, hôpital Cochin, AP-HP , 75014 Paris, France
| | - Chloé Broudin
- Service de pathologie, hôpital Cochin, AP-HP , 75014 Paris, France
| | - Diane Damotte
- Service de pathologie, hôpital Cochin, AP-HP , 75014 Paris, France; Inserm U1138, centre de recherche des Cordeliers, 15, rue de l'École de Médecine, 75006 Paris, France; Université Paris Descartes, 75006 Paris, France; Université Pierre-et-Marie-Curie, 75005 Paris, France.
| | - Camille Laurent
- Département de pathologie, institut universitaire du cancer-oncopole de Toulouse, 31059 Toulouse, France; Service de pathologie et cytologie, centre hospitalier universitaire, 31300 Toulouse, France; Inserm UMR1037, centre de recherches en cancérologie de Toulouse, 31100 Toulouse, France
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59
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Sun R, Medeiros LJ, Young KH. Diagnostic and predictive biomarkers for lymphoma diagnosis and treatment in the era of precision medicine. Mod Pathol 2016; 29:1118-42. [PMID: 27363492 DOI: 10.1038/modpathol.2016.92] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 04/13/2016] [Accepted: 04/14/2016] [Indexed: 02/07/2023]
Abstract
Lymphomas are a group of hematological malignancies derived from lymphocytes. Lymphomas are clinically and biologically heterogeneous and have overlapping diagnostic features. With the advance of new technologies and the application of efficient and feasible detection platforms, an unprecedented number of novel biomarkers have been discovered or are under investigation at the genetic, epigenetic, and protein level as well as the tumor microenvironment. These biomarkers have enabled new clinical and pathological insights into the mechanisms underlying lymphomagenesis and also have facilitated improvements in the diagnostic workup, sub-classification, outcome stratification, and personalized therapy for lymphoma patients. However, integrating these biomarkers into clinical practice effectively and precisely in daily practice is challenging. More in-depth studies are required to further validate these novel biomarkers and to assess other parameters that can affect the reproducibility of these biomarkers such as the selection of detection methods, biological reagents, interpretation of data, and cost efficiency. Despite these challenges, there are many reasons to be optimistic that novel biomarkers will facilitate better algorithms and strategies as we enter a new era of precision medicine to better refine diagnosis, prognostication, and rational treatment design for patients with lymphomas.
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Affiliation(s)
- Ruifang Sun
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,Department of Pathology, Shanxi Cancer Hospital, Shanxi, China
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ken H Young
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,The University of Texas Graduate School of Biomedical Science, Houston, TX, USA
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60
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Kim WY, Jung HY, Nam SJ, Kim TM, Heo DS, Kim CW, Jeon YK. Expression of programmed cell death ligand 1 (PD-L1) in advanced stage EBV-associated extranodal NK/T cell lymphoma is associated with better prognosis. Virchows Arch 2016; 469:581-590. [DOI: 10.1007/s00428-016-2011-0] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 07/06/2016] [Accepted: 08/29/2016] [Indexed: 11/30/2022]
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61
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Gravelle P, Do C, Franchet C, Mueller S, Oberic L, Ysebaert L, Larocca LM, Hohaus S, Calmels MN, Frenois FX, Kridel R, Gascoyne RD, Laurent G, Brousset P, Valitutti S, Laurent C. Impaired functional responses in follicular lymphoma CD8 +TIM-3 + T lymphocytes following TCR engagement. Oncoimmunology 2016; 5:e1224044. [PMID: 27990323 DOI: 10.1080/2162402x.2016.1224044] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 08/03/2016] [Accepted: 08/09/2016] [Indexed: 12/31/2022] Open
Abstract
Upregulation of T cell immunoglobulin-3 (TIM-3) has been associated with negative regulation of the immune response in chronic infection and cancer, including lymphoma. Here, we investigated the possible correlation between TIM-3 expression by ex vivo cytotoxic T cells (CTL) from follicular lymphoma (FL) biopsies and their functional unresponsiveness that could limit the favorable impact of CTL on disease progression. We report a high percentage of CD8+TIM-3+T cells in lymph nodes of FL patients. When compared to their CD8+TIM-3- counterparts, CD8+TIM-3+ T cells exhibited defective cytokine production following TCR engagement. Furthermore, CD8+TIM-3+ T cells display ex vivo markers of lytic granule release and remain unresponsive to further TCR-induced activation of the lytic machinery. Although confocal microscopy showed that TIM-3 expression on CD8+ T cells correlated with minor alterations of immunological synapse, a selective reduction of ERK signaling in CD8+TIM-3+T cells was observed by phospho-flow analysis. Finally, short relapse-free survival despite rituximab(R)-chemotherapy was observed in patients with high content of TIM-3+ cells and a poor infiltrate of granzyme B+ T cells in FL lymph nodes. Together, our data indicate that, besides selective TCR early signaling defects, TIM-3 expression correlates with unresponsiveness of ex vivo CD8+ T cells in FL. They show that scores based on the combination of exhaustion and cytolytic markers in FL microenvironment might be instrumental to identify patients at early risk of relapses following R-chemotherapy.
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Affiliation(s)
- Pauline Gravelle
- Centre de Physiopathologie de Toulouse Purpan, INSERM U1043, Toulouse, France; Département de Pathologie, Institut Universitaire du Cancer-Oncopole de Toulouse, Toulouse, France; Laboratoire d'Excellence "TOUCAN," Toulouse, France; Program Hospitalo-Universitaire en Cancérologie "CAPTOR," Toulouse, France; CALYM Carnot Institute, Pierre-Bénite, France
| | - Catherine Do
- Institute for Cancer Genetics, Columbia University , New York, USA
| | - Camille Franchet
- Centre de Physiopathologie de Toulouse Purpan, INSERM U1043, Toulouse, France; Département de Pathologie, Institut Universitaire du Cancer-Oncopole de Toulouse, Toulouse, France; Université Toulouse III Paul-Sabatier, Toulouse, France
| | - Sabina Mueller
- Centre de Physiopathologie de Toulouse Purpan, INSERM U1043, Toulouse, France; Laboratoire d'Excellence "TOUCAN," Toulouse, France
| | - Lucie Oberic
- Program Hospitalo-Universitaire en Cancérologie "CAPTOR," Toulouse, France; Département d'Hématologie, Institut Universitaire du Cancer-Oncopole de Toulouse, Toulouse, France
| | - Loïc Ysebaert
- Laboratoire d'Excellence "TOUCAN," Toulouse, France; Program Hospitalo-Universitaire en Cancérologie "CAPTOR," Toulouse, France; CALYM Carnot Institute, Pierre-Bénite, France; Université Toulouse III Paul-Sabatier, Toulouse, France; Département d'Hématologie, Institut Universitaire du Cancer-Oncopole de Toulouse, Toulouse, France; Centre de Recherches en Cancérologie de Toulouse, INSERM UMR1037, Toulouse, France
| | - Luigi Maria Larocca
- Istituto di Anatomia Patologica, Università Cattolica del Sacro Cuore , Roma, Italy
| | - Stefan Hohaus
- Istituto di Ematologia, Università Cattolica del Sacro Cuore , Roma, Italy
| | | | - François-Xavier Frenois
- Département de Pathologie, Institut Universitaire du Cancer-Oncopole de Toulouse , Toulouse, France
| | - Robert Kridel
- Center for Lymphoid Cancer, BC Cancer Agency , Vancouver, BC, Canada
| | - Randy D Gascoyne
- Center for Lymphoid Cancer, BC Cancer Agency , Vancouver, BC, Canada
| | - Guy Laurent
- Laboratoire d'Excellence "TOUCAN," Toulouse, France; Program Hospitalo-Universitaire en Cancérologie "CAPTOR," Toulouse, France; CALYM Carnot Institute, Pierre-Bénite, France; Université Toulouse III Paul-Sabatier, Toulouse, France; Département d'Hématologie, Institut Universitaire du Cancer-Oncopole de Toulouse, Toulouse, France; Centre de Recherches en Cancérologie de Toulouse, INSERM UMR1037, Toulouse, France
| | - Pierre Brousset
- Département de Pathologie, Institut Universitaire du Cancer-Oncopole de Toulouse, Toulouse, France; Laboratoire d'Excellence "TOUCAN," Toulouse, France; Program Hospitalo-Universitaire en Cancérologie "CAPTOR," Toulouse, France; CALYM Carnot Institute, Pierre-Bénite, France; Université Toulouse III Paul-Sabatier, Toulouse, France; Centre de Recherches en Cancérologie de Toulouse, INSERM UMR1037, Toulouse, France
| | - Salvatore Valitutti
- Centre de Physiopathologie de Toulouse Purpan, INSERM U1043, Toulouse, France; Département de Pathologie, Institut Universitaire du Cancer-Oncopole de Toulouse, Toulouse, France; Laboratoire d'Excellence "TOUCAN," Toulouse, France; Université Toulouse III Paul-Sabatier, Toulouse, France
| | - Camille Laurent
- Centre de Physiopathologie de Toulouse Purpan, INSERM U1043, Toulouse, France; Département de Pathologie, Institut Universitaire du Cancer-Oncopole de Toulouse, Toulouse, France; Laboratoire d'Excellence "TOUCAN," Toulouse, France; Program Hospitalo-Universitaire en Cancérologie "CAPTOR," Toulouse, France; CALYM Carnot Institute, Pierre-Bénite, France; Université Toulouse III Paul-Sabatier, Toulouse, France; Centre de Recherches en Cancérologie de Toulouse, INSERM UMR1037, Toulouse, France
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62
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Magnano L, Martínez A, Carreras J, Martínez-Trillos A, Giné E, Rovira J, Dlouhy I, Baumann T, Balagué O, Campo E, López-Guillermo A, Villamor N. T-cell subsets in lymph nodes identify a subgroup of follicular lymphoma patients with favorable outcome. Leuk Lymphoma 2016; 58:842-850. [DOI: 10.1080/10428194.2016.1217525] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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63
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PD-L1 expression on neoplastic or stromal cells is respectively a poor or good prognostic factor for adult T-cell leukemia/lymphoma. Blood 2016; 128:1374-81. [PMID: 27418641 DOI: 10.1182/blood-2016-02-698936] [Citation(s) in RCA: 98] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 07/05/2016] [Indexed: 12/11/2022] Open
Abstract
Programmed cell death ligand 1 (PD-L1) is expressed on both tumor and tumor-infiltrating nonmalignant cells in lymphoid malignancies. The programmed cell death 1 (PD-1)/PD-L1 pathway suppresses host antitumor responses, although little is known about the significance of PD-1/PD-L1 expression in the tumor microenvironment. To investigate the clinicopathological impact of PD-L1 expression in adult T-cell leukemia/lymphoma (ATLL), we performed PD-L1 immunostaining in 135 ATLL biopsy samples. We observed 2 main groups: 1 had clear PD-L1 expression in lymphoma cells (nPD-L1(+), 7.4% of patients), and the other showed minimal expression in lymphoma cells (nPD-L1(-), 92.6%). Within the nPD-L1(-) group, 2 subsets emerged: the first displayed abundant PD-L1 expression in nonmalignant stromal cells of the tumor microenvironment (miPD-L1(+), 58.5%) and the second group did not express PD-L1 in any cell (PD-L1(-), 34.1%). nPD-L1(+) ATLL (median survival time [MST] 7.5 months, 95% CI [0.4-22.3]) had inferior overall survival (OS) compared with nPD-L1(-) ATLL (MST 14.5 months, 95% CI [10.1-20.0]) (P = .0085). Among nPD-L1(-) ATLL, miPD-L1(+) ATLL (MST 18.6 months, 95% CI [11.0-38.5]) showed superior OS compared with PD-L1(-) ATLL (MST 10.2 months, 95% CI [8.0-14.7]) (P = .0029). The expression of nPD-L1 and miPD-L1 maintained prognostic value for OS in multivariate analysis (P = .0322 and P = .0014, respectively). This is the first report describing the clinicopathological features and outcomes of PD-L1 expression in ATLL. More detailed studies will disclose clinical and biological significance of PD-L1 expression in ATLL.
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64
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Bhatt S, Sarosiek KA, Lossos IS. Interleukin 21 - its potential role in the therapy of B-cell lymphomas. Leuk Lymphoma 2016; 58:17-29. [PMID: 27405876 DOI: 10.1080/10428194.2016.1201568] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Interleukin-21 (IL-21), a member of IL-2 cytokine family, has pleotropic biological effects on lymphoid and myeloid cells. During the past 15 years, since the discovery of IL-21, great advances have been made regarding its biological activity and the mechanisms controlling IL-21-mediated cellular responses, especially in hematological malignancies. Preclinical studies have shown that IL-21R is expressed on healthy and neoplastic B-cells and exogenous IL-21 can induce direct apoptosis of IL-21R expressing B-cell non-Hodgkin lymphomas (NHL), making it a potentially attractive anti-lymphoma therapy. However, in some hematological malignancies such as multiple myeloma, Hodgkin lymphoma and Burkitt lymphoma, IL-21 can induce proliferation of neoplastic B-cells. In NHL, the underlying mechanism of cell death was found to be different between the various subtypes, including activation of different JAK/STAT signal transduction pathways or other factors. Immunomodulatory effects of IL-21 have also been reported to contribute to its anti-tumor effects as described by earlier studies in solid tumors and B-cell associated malignancies. These effects are predominantly mediated by IL-21's ability to activate cytolytic activities by NK-cells and CD4+/CD8+ T-cells. In this review, we provide an overview of IL-21's effects in NHL, results from clinical trials utilizing IL-21, and propose how IL-21 can be therapeutically exploited for treating these lymphomas.
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Affiliation(s)
- Shruti Bhatt
- a Dana-Farber Cancer Institute/Harvard Medical School , Boston , MA , USA
| | | | - Izidore S Lossos
- b Department of Molecular and Cellular Pharmacology , University of Miami Miller School of Medicine , Miami , FL , USA.,c Department of Medicine, Division of Hematology-Oncology , Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine , Miami , FL , USA
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65
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Blaker YN, Spetalen S, Brodtkorb M, Lingjaerde OC, Beiske K, Østenstad B, Sander B, Wahlin BE, Melen CM, Myklebust JH, Holte H, Delabie J, Smeland EB. The tumour microenvironment influences survival and time to transformation in follicular lymphoma in the rituximab era. Br J Haematol 2016; 175:102-14. [PMID: 27341313 DOI: 10.1111/bjh.14201] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 05/04/2016] [Indexed: 01/10/2023]
Abstract
The tumour microenvironment influences outcome in patients with follicular lymphoma (FL), but its impact on transformation is less studied. We investigated the prognostic significance of the tumour microenvironment on transformation and survival in FL patients treated in the rituximab era. We examined diagnostic and transformed biopsies from 52 FL patients using antibodies against CD3, CD4, CD8, CD21 (CR2), CD57 (B3GAT1), CD68, FOXP3, TIA1, PD-1 (PDCD1), PD-L1 (CD274) and PAX5. Results were compared with a second cohort of 40 FL patients without signs of transformation during a minimum of five years observation time. Cell numbers and localization were semi-quantitatively assessed. Better developed CD21+ follicular dendritic cell (FDC) meshworks at diagnosis was a negative prognostic factor for overall survival (OS), progression-free survival (PFS) and time to transformation (TTT) in patients with subsequently transformed FL. Remnants of FDC meshworks at transformation were associated with shorter OS and PFS from transformation. High degrees of intrafollicular CD68+ and PD-L1+ macrophage infiltration, high total area scores and an extrafollicular/diffuse pattern of FOXP3+ T cells and high intrafollicular scores of CD4+ T cells at diagnosis were associated with shorter TTT. Scores of several T-cell subset markers from the combined patient cohorts were predictive for transformation, especially CD4 and CD57.
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Affiliation(s)
- Yngvild Nuvin Blaker
- Centre for Cancer Biomedicine, Faculty of Medicine, University of Oslo, Oslo, Norway. .,Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway.
| | - Signe Spetalen
- Department of Pathology, Division of Cancer Medicine, Surgery and Transplantation, Oslo University Hospital, Oslo, Norway
| | - Marianne Brodtkorb
- Centre for Cancer Biomedicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway.,Department of Oncology, Division of Cancer Medicine, Surgery and Transplantation, Oslo University Hospital, Oslo, Norway
| | - Ole Christian Lingjaerde
- Section for Biomedical Informatics, Department of Computer Science, University of Oslo, Oslo, Norway
| | - Klaus Beiske
- Department of Pathology, Division of Cancer Medicine, Surgery and Transplantation, Oslo University Hospital, Oslo, Norway
| | - Bjørn Østenstad
- Department of Oncology, Division of Cancer Medicine, Surgery and Transplantation, Oslo University Hospital, Oslo, Norway
| | - Birgitta Sander
- Department of Laboratory Medicine, Division of Pathology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Björn Engelbrekt Wahlin
- Division of Haematology, Department of Medicine at Huddinge, Karolinska Institutet and Haematology Centre, Karolinska University Hospital, Stockholm, Sweden
| | - Christopher Michael Melen
- Division of Haematology, Department of Medicine at Huddinge, Karolinska Institutet and Haematology Centre, Karolinska University Hospital, Stockholm, Sweden
| | - June Helen Myklebust
- Centre for Cancer Biomedicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
| | - Harald Holte
- Centre for Cancer Biomedicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Oncology, Division of Cancer Medicine, Surgery and Transplantation, Oslo University Hospital, Oslo, Norway
| | - Jan Delabie
- Department of Pathology, University of Toronto, Toronto, Canada
| | - Erlend Bremertun Smeland
- Centre for Cancer Biomedicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
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66
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Le KS, Thibult ML, Just-Landi S, Pastor S, Gondois-Rey F, Granjeaud S, Broussais F, Bouabdallah R, Colisson R, Caux C, Ménétrier-Caux C, Leroux D, Xerri L, Olive D. Follicular B Lymphomas Generate Regulatory T Cells via the ICOS/ICOSL Pathway and Are Susceptible to Treatment by Anti-ICOS/ICOSL Therapy. Cancer Res 2016; 76:4648-60. [PMID: 27246829 DOI: 10.1158/0008-5472.can-15-0589] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 05/09/2016] [Indexed: 11/16/2022]
Abstract
The prognosis of follicular lymphoma (FL) patients is suspected to be influenced by tumor-infiltrating regulatory T cells (Treg). The mechanism of Treg enrichment in FL and their impact on malignant FL B cells remains to be elucidated. We analyzed 46 fresh lymph node biopsy samples, including FL (n = 20), diffuse large B-cell lymphoma (n = 10), classical Hodgkin lymphoma (n = 9), and reactive lymphadenitis (n = 7). Using multicolor flow cytometry and cell sorting, we observed an accumulation of CD25(high)CD127(low/neg) Tregs in FL tissues. These Tregs comprised activated ICOS(+) Tregs that were able to suppress not only conventional T cells, but also FL B cells. These FL B cells were able to express ICOSL in vitro and to generate CD25(high)FoxP3(high) Tregs expressing ICOS. Treg generation was associated with ICOS/ICOSL engagement and was abrogated by antagonist anti-ICOS and anti-ICOSL antibodies. Interactions between Tregs and FL B cells resulted in ICOSL downregulation on FL B cells. Our results highlight a key role for Tregs in FL pathogenesis and suggest that targeting the ICOS/ICOSL pathway may be a promising immunotherapy for FL treatment. Cancer Res; 76(16); 4648-60. ©2016 AACR.
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Affiliation(s)
- Kieu-Suong Le
- Centre de recherche en Cancérologie de Marseille, Inserm U1068/CNRS U7258, Marseille, France. Aix Marseille Université, Marseille, France
| | - Marie-Laure Thibult
- Centre de recherche en Cancérologie de Marseille, Inserm U1068/CNRS U7258, Marseille, France. Institut Paoli - Calmettes, Marseille, France
| | | | - Sonia Pastor
- Centre de recherche en Cancérologie de Marseille, Inserm U1068/CNRS U7258, Marseille, France
| | - Françoise Gondois-Rey
- Centre de recherche en Cancérologie de Marseille, Inserm U1068/CNRS U7258, Marseille, France
| | - Samuel Granjeaud
- Centre de recherche en Cancérologie de Marseille, Inserm U1068/CNRS U7258, Marseille, France
| | | | | | - Renaud Colisson
- Centre de Recherche en Cancérologie de Lyon, Inserm U1052/CNRS 5286, Lyon, France
| | - Christophe Caux
- Centre de Recherche en Cancérologie de Lyon, Inserm U1052/CNRS 5286, Lyon, France
| | | | | | - Luc Xerri
- Centre de recherche en Cancérologie de Marseille, Inserm U1068/CNRS U7258, Marseille, France. Aix Marseille Université, Marseille, France. Institut Paoli - Calmettes, Marseille, France
| | - Daniel Olive
- Centre de recherche en Cancérologie de Marseille, Inserm U1068/CNRS U7258, Marseille, France. Aix Marseille Université, Marseille, France. Institut Paoli - Calmettes, Marseille, France.
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Nedelkovska H, Rosenberg AF, Hilchey SP, Hyrien O, Burack WR, Quataert SA, Baker CM, Azadniv M, Welle SL, Ansell SM, Kim M, Bernstein SH. Follicular Lymphoma Tregs Have a Distinct Transcription Profile Impacting Their Migration and Retention in the Malignant Lymph Node. PLoS One 2016; 11:e0155347. [PMID: 27228053 PMCID: PMC4882026 DOI: 10.1371/journal.pone.0155347] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 04/06/2016] [Indexed: 01/25/2023] Open
Abstract
We have previously shown that regulatory T cells (Tregs) infiltrating follicular lymphoma lymph nodes are quantitatively and qualitatively different than those infiltrating normal and reactive nodes. To gain insight into how such Treg populations differ, we performed RNA sequence (RNAseq) analyses on flow sorted Tregs from all three sources. We identify several molecules that could contribute to the observed increased suppressive capacity of follicular lymphoma nodal tregs, including upregulation of CTLA-4, IL-10, and GITR, all confirmed by protein expression. In addition, we identify, and confirm functionally, a novel mechanism by which Tregs target to and accumulate within a human tumor microenvironment, through the down regulation of S1PR1, SELL (L-selectin) and CCR7, potentially resulting in greater lymph node retention. In addition we identify and confirm functionally the upregulation of the chemokine receptor CXCR5 as well as the secretion of the chemokines CXCL13 and IL-16 demonstrating the unique ability of the follicular derived Tregs to localize and accumulate within not only the malignant lymph node, but also localize and accumulate within the malignant B cell follicle itself. Such findings offer significant new insights into how follicular lymphoma nodal Tregs may contribute to the biology of follicular lymphoma and identify several novel therapeutic targets.
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Affiliation(s)
- Hristina Nedelkovska
- James P. Wilmot Cancer Center, Lymphoma Biology Program, Department of Medicine University of Rochester Medical Center, Rochester, New York, United States of America
| | - Alexander F. Rosenberg
- Division of Allergy, Immunology, and Rheumatology, Department of Medicine, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Shannon P. Hilchey
- James P. Wilmot Cancer Center, Lymphoma Biology Program, Department of Medicine University of Rochester Medical Center, Rochester, New York, United States of America
| | - Ollivier Hyrien
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, New York, United States of America
| | - W. Richard Burack
- James P. Wilmot Cancer Center, Lymphoma Biology Program, Department of Medicine University of Rochester Medical Center, Rochester, New York, United States of America
| | - Sally A. Quataert
- David H. Smith Center for Vaccine Biology and Immunology, Aab Institute of Biomedical Sciences, Department of Microbiology and Immunology, University of Rochester Medical Center, Rochester New York, United States of America
| | - Christina M. Baker
- David H. Smith Center for Vaccine Biology and Immunology, Aab Institute of Biomedical Sciences, Department of Microbiology and Immunology, University of Rochester Medical Center, Rochester New York, United States of America
| | - Mitra Azadniv
- James P. Wilmot Cancer Center, Lymphoma Biology Program, Department of Medicine University of Rochester Medical Center, Rochester, New York, United States of America
| | - Stephen L. Welle
- University of Rochester Genomics Research Center, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Stephen M. Ansell
- Division of Hematology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Minsoo Kim
- David H. Smith Center for Vaccine Biology and Immunology, Aab Institute of Biomedical Sciences, Department of Microbiology and Immunology, University of Rochester Medical Center, Rochester New York, United States of America
| | - Steven H. Bernstein
- James P. Wilmot Cancer Center, Lymphoma Biology Program, Department of Medicine University of Rochester Medical Center, Rochester, New York, United States of America
- * E-mail:
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68
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Yokoyama S, Miyoshi H, Nakashima K, Shimono J, Hashiguchi T, Mitsuoka M, Takamori S, Akagi Y, Ohshima K. Prognostic Value of Programmed Death Ligand 1 and Programmed Death 1 Expression in Thymic Carcinoma. Clin Cancer Res 2016; 22:4727-34. [PMID: 27166394 DOI: 10.1158/1078-0432.ccr-16-0434] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 05/03/2016] [Indexed: 01/22/2023]
Abstract
PURPOSE The immune checkpoint of the programmed death 1/programmed death ligand 1 (PD-1/PD-L1) pathway is believed to play an important role in evasion of host antitumor immune surveillance in various malignancies; however, little is known about its role in thymic carcinoma. This study investigated PD-1/PD-L1 expression and its association with clinicopathologic features, the expression of immune-related proteins in tumor-infiltrating lymphocytes (TIL), and patient prognosis. EXPERIMENTAL DESIGN PD-L1 and PD-1 expression was evaluated by IHC in 25 thymic carcinoma tissue specimens. Copy number alterations of the PD-L1 gene in 11 cases were assessed in formalin-fixed, paraffin-embedded material using qRT-PCR. RESULTS Compared with normal subjects, 3 thymic carcinoma patients showed an increase in PD-L1 copy number, whereas 8 did not. PD-L1 was significantly overexpressed in cases with copy number gain as compared with normal cases. High PD-L1 expression was associated with higher disease-free and overall survival rates as compared to cases with low expression. Prognostic analysis revealed low PD-L1 expression and high number of PD-1(+) TILs as significant predictors of poor survival, together with Masaoka-Koga stage IVa/IVb disease and incomplete resection. In the quantitative analysis of TILs, PD-L1 expression correlated proportionally with the number of infiltrating CTLs. CONCLUSIONS Here, for the first time, we report that PD-L1 and PD-1 expression might be useful prognostic predictors in thymic carcinoma. Further studies are expected to substantiate the prognostic value of PD-L1 and PD-1 expression, and the potential efficacy of targeting the PD-1/PD-L1 pathway in thymic carcinoma via immunotherapy. Clin Cancer Res; 22(18); 4727-34. ©2016 AACR.
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Affiliation(s)
- Shintaro Yokoyama
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan.
| | - Kazutaka Nakashima
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Joji Shimono
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Toshihiro Hashiguchi
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan. Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Masahiro Mitsuoka
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Shinzo Takamori
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Yoshito Akagi
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
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Abstract
PURPOSE OF REVIEW The development of 'immune checkpoint inhibitors' or drugs targeting the programmed death-1 (PD-1)/programmed death-ligand 1 (PD-L1) axis has been a stunning success of cancer immunotherapy. This review provides a timely overview of the biology and function of the PD-1 pathway and discusses the rationale for therapeutic inhibition of this pathway in lymphoma. RECENT FINDINGS Recent studies have evaluated the prevalence and prognostic implications of PD-1, PD-L1/2 expression in various lymphoma subtypes. We present an overview of the clinical trials evaluating pidilizumab, nivolumab, and pembrolizumab in patients with lymphoid malignancies, and highlight some of the more promising agents in this class, currently in development. Finally, we discuss biomarkers that may predict response to therapy in patients with lymphoma across these clinical trials. SUMMARY A plethora of clinical trials are in progress testing immune checkpoint inhibitors in many subtypes of lymphoma, which will define their role both as a monotherapy and in combination with other biologic agents.
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70
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Sugimoto T, Watanabe T. Follicular Lymphoma: The Role of the Tumor Microenvironment in Prognosis. J Clin Exp Hematop 2016; 56. [PMID: 27334853 PMCID: PMC6247780 DOI: 10.3960/jslrt.5601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
The microenvironment of follicular lymphoma (FL) is composed of tumor-infiltrating CD8(+) T cells, follicular regulatory T cells, lymphoma-associated macrophages and mast cells, follicular helper T cells, follicular dendritic cells, and follicular reticular cells, all of which have been reported to have relevance in the prognosis of FL patients. In addition, some of these cells play a role in the histologic transformation of FL. Macrophages contribute to a poor prognosis in FL patients treated in the pre-rituximab era, but are associated with good prognosis in those treated in the rituximab era. T-cell immunoglobulin and mucin domain protein (TIM) 3 are markers of T-cell exhaustion, and T cells co-expressing programed death 1 (PD1) in peripheral blood and lymph nodes secrete interleukin (IL)-12 in the serum. Serum CXCL9, IL-2 receptor, and IL-1 receptor agonist are associated with shorter survival of FL patients. Agents for manipulation of the microenvironment surrounding FL cells include the immunomodulatory drug lenalidomide, immune check-point inhibitors, and cyclophosphamide prior to rituximab. To battle FL and to improve the outcomes of FL patients, understanding the relationship between neoplastic cells and the various microenvironmental cellular components is crucial for developing therapeutics against the microenvironment.
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71
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Lenalidomide potentiates CD4+CD25+Treg-related suppression of lymphoma B-cell proliferation. Clin Exp Med 2016; 17:193-207. [DOI: 10.1007/s10238-016-0411-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 02/12/2016] [Indexed: 10/22/2022]
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Abstract
PURPOSE OF REVIEW The purpose of this article is to discuss the tumor microenvironment in lymphoma, and to review potential immune targets that are now becoming relevant because of clinical responses seen with the use of immune checkpoint inhibitors. RECENT FINDINGS Recent data have shown that cells within the immune microenvironment in lymphoma express programmed death ligand-1 (PD-L1) and many of the intratumoral T cells with an exhausted immune phenotype express programmed cell death-1 (PD-1). This provides a novel opportunity to inhibit the immune checkpoints and initial clinical trials utilizing antibodies that block the interaction between PD-1 and PD-L1 have demonstrated significant clinical responses in various lymphomas, including Hodgkin lymphoma. SUMMARY The use of immune checkpoint inhibitors, including nivolumab and pembrolizumab, in relapsed and refractory patients with lymphoma is proving highly successful. Patients with Hodgkin lymphoma, in particular, have a very high response rate to PD-1 blockade and responses in these patients appear durable.
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74
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Grygorowicz MA, Biernacka M, Bujko M, Nowak E, Rymkiewicz G, Paszkiewicz-Kozik E, Borycka IS, Bystydzienski Z, Walewski J, Markowicz S. Human regulatory T cells suppress proliferation of B lymphoma cells. Leuk Lymphoma 2016; 57:1903-20. [DOI: 10.3109/10428194.2015.1121260] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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75
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Chevalier N, Mueller M, Mougiakakos D, Ihorst G, Marks R, Schmitt-Graeff A, Veelken H. Analysis of dendritic cell subpopulations in follicular lymphoma with respect to the tumor immune microenvironment. Leuk Lymphoma 2016; 57:2150-60. [PMID: 26757600 DOI: 10.3109/10428194.2015.1135432] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The immune cell composition of the follicular lymphoma (FL) tumor microenvironment is increasingly recognized as an important determinant for clinical outcome. Here, we explored frequency and distribution of dendritic cell (DC) subtypes in relation to regulatory T cells (Treg) by immunohistochemistry in lymph node biopsies from patients with de novo FL. We found that neoplastic follicles contained lower DC and higher Treg frequencies than hyperplastic follicles in control lymph nodes. Treg numbers particularly correlated with the subset of conventional CD11c(+ )DCs. Additionally, both a high intra- to interfollicular ratio of CD11c(+ )DCs and increased intrafollicular Treg frequencies were associated with decreased overall survival. This suggests that functional interactions between these cells may be relevant for FL progression/recurrence. The presence of CD11c(+ )DCs in the tumor microenvironment may assist tumor infiltration by Tregs, thus contributing to the suppression of an otherwise beneficial T-cell-dominated FL microenvironment.
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Affiliation(s)
- Nina Chevalier
- a Department of Rheumatology/Clinical Immunology , University Medical Centre Freiburg , Freiburg , Germany
| | - Michael Mueller
- b Department of Hematology/Oncology , University Medical Centre Freiburg , Freiburg , Germany
| | - Dimitrios Mougiakakos
- c Department of Hematology and Oncology , University of Erlangen-Nuremberg , Erlangen , Germany
| | - Gabriele Ihorst
- d Department of Medical Biometry and Statistics , University Medical Centre Freiburg , Freiburg , Germany
| | - Reinhard Marks
- b Department of Hematology/Oncology , University Medical Centre Freiburg , Freiburg , Germany
| | | | - Hendrik Veelken
- f Department of Hematology , Leiden University Medical Centre , Leiden , the Netherlands
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Xia Y, Jeffrey Medeiros L, Young KH. Signaling pathway and dysregulation of PD1 and its ligands in lymphoid malignancies. Biochim Biophys Acta Rev Cancer 2015; 1865:58-71. [PMID: 26432723 DOI: 10.1016/j.bbcan.2015.09.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 09/24/2015] [Accepted: 09/26/2015] [Indexed: 12/12/2022]
Abstract
Tumor cells evade immune destruction, at least partially, by upregulating inhibitory signals to limit effector T cell activation. Programmed death 1 (PD-1) is one of the most critical co-inhibitory molecules limiting the T-cell antitumor response. PD-1 and its ligands, PD-L1 and PD-L2, are overexpressed by various types of tumors as well as reactive cells in the tumor microenvironment. A growing body of evidence has shown the clinical efficiency and minimal toxicity of PD-1 pathway inhibitors in patients with solid tumors, but the role of these inhibitors in lymphoid malignancies is much less well studied. In this review, we analyze the pathologic role of the PD-1 pathway in most common lymphoid malignancies and we organize the clinical data from clinical trials of PD-1 pathway inhibitors. Several anti-PD-1 regimens have shown encouraging therapeutic effects in patients with relapsed or refractory Hodgkin lymphoma, follicular lymphoma, and diffuse large B-cell lymphoma. Additional progress is needed to foster an improved understanding of the role of anti-PD-1 therapy in reconstituting antitumor immunity in patients with lymphoid malignancies. Upcoming trials will explore the clinical efficiency of combining PD-1 pathway inhibitors and various agents with diverse mechanisms of action and create more therapeutic possibilities for afflicted patients.
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Affiliation(s)
- Yi Xia
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ken H Young
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; The University of Texas Graduate School of Biomedical Science, Houston, TX, USA.
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77
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Nelson LS, Mansfield JR, Lloyd R, Oguejiofor K, Salih Z, Menasce LP, Linton KM, Rose CJ, Byers RJ. Automated prognostic pattern detection shows favourable diffuse pattern of FOXP3(+) Tregs in follicular lymphoma. Br J Cancer 2015; 113:1197-205. [PMID: 26439683 PMCID: PMC4647874 DOI: 10.1038/bjc.2015.291] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 06/30/2015] [Accepted: 07/11/2015] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Histopathological prognostication relies on morphological pattern recognition, but as numbers of biomarkers increase, human prognostic pattern-recognition ability decreases. Follicular lymphoma (FL) has a variable outcome, partly determined by FOXP3 Tregs. We have developed an automated method, hypothesised interaction distribution (HID) analysis, to analyse spatial patterns of multiple biomarkers which we have applied to tumour-infiltrating lymphocytes in FL. METHODS A tissue microarray of 40 patient samples was used in triplex immunohistochemistry for FOXP3, CD3 and CD69, and multispectral imaging used to determine the numbers and locations of CD3(+), FOXP3/CD3(+) and CD69/CD3(+) T cells. HID analysis was used to identify associations between cellular pattern and outcome. RESULTS Higher numbers of CD3(+) (P=0.0001), FOXP3/CD3(+) (P=0.0031) and CD69/CD3(+) (P=0.0006) cells were favourable. Cross-validated HID analysis of cell pattern identified patient subgroups with statistically significantly different survival (35.5 vs 142 months, P=0.00255), a more diffuse pattern associated with favourable outcome and an aggregated pattern with unfavourable outcome. CONCLUSIONS A diffuse pattern of FOXP3 and CD69 positivity was favourable, demonstrating ability of HID analysis to automatically identify prognostic cellular patterns. It is applicable to large numbers of biomarkers, representing an unsupervised, automated method for identification of undiscovered prognostic cellular patterns in cancer tissue samples.
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Affiliation(s)
- Lilli S Nelson
- Medical School, The University of Manchester, Oxford Road, Manchester M13 9PT, UK
| | | | - Roslyn Lloyd
- Perkin-Elmer, 68 Elm Street, Hopkinton, Massachusetts 01748, USA
| | - Kenneth Oguejiofor
- Institute of Cancer Sciences, The University of Manchester, Oxford Road, Manchester M13 9PT, UK
| | - Zena Salih
- Department of Medical Oncology, The Christie Foundation NHS Trust, 550 Wilmslow Rd, Manchester M20 4BX, UK
| | - Lia P Menasce
- Department of Histopathology, The Christie Foundation NHS Trust, 550 Wilmslow Rd, Manchester M20 4BX, UK
| | - Kim M Linton
- Institute of Cancer Sciences, The University of Manchester, Oxford Road, Manchester M13 9PT, UK.,Department of Medical Oncology, The Christie Foundation NHS Trust, 550 Wilmslow Rd, Manchester M20 4BX, UK
| | - Chris J Rose
- Institute of Population Health, The University of Manchester, Oxford Road, Manchester M13 9PT, UK.,Manchester Academic Health Science Centre, The University of Manchester, Oxford Road, Manchester M13 9PT, UK
| | - Richard J Byers
- Institute of Cancer Sciences, The University of Manchester, Oxford Road, Manchester M13 9PT, UK.,Manchester Academic Health Science Centre, The University of Manchester, Oxford Road, Manchester M13 9PT, UK.,Department of Histopathology, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK
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78
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Expression of programmed cell death ligand 1 is associated with poor overall survival in patients with diffuse large B-cell lymphoma. Blood 2015; 126:2193-201. [PMID: 26239088 DOI: 10.1182/blood-2015-02-629600] [Citation(s) in RCA: 359] [Impact Index Per Article: 39.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 07/27/2015] [Indexed: 01/22/2023] Open
Abstract
Programmed cell death ligand 1 (PD-L1) is expressed on both select diffuse large B-cell lymphoma (DLBCL) tumor cells and on tumor-infiltrating nonmalignant cells. The programmed cell death 1 (PD-1)/PD-L1 pathway inhibits host antitumor responses; however, little is known about how this pathway functions in the tumor microenvironment. The aim of this study was to determine the clinicopathological impact of PD-L1(+) DLBCL. We performed PD-L1/PAX5 double immunostaining in 1253 DLBCL biopsy samples and established a new definition of PD-L1(+) DLBCL. We also defined the criteria for microenvironmental PD-L1(+) (mPD-L1(+)) DLBCL (ie, PD-L1(-) DLBCL in which PD-L1(+) nonmalignant cells are abundant in the tumor microenvironment). Of the 273 patients whose clinical information was available, quantitative analysis of PD-1(+) tumor-infiltrating lymphocytes (TILs) was performed. The prevalence rates of PD-L1(+) and mPD-L1(+) DLBCL were 11% and 15.3%, respectively. Both PD-L1(+) and mPD-L1(+) DLBCL were significantly associated with non-germinal center B-cell (GCB) type and Epstein-Barr virus positivity. The number of PD-1(+) TILs was significantly higher in GCB-type tumors and lower in mPD-L1(-) and PD-L1(+) DLBCL. Patients with PD-L1(+) DLBCL had inferior overall survival (OS) compared with that in patients with PD-L1(-) DLBCL (P = .0009). In contrast, there was no significant difference in OS between mPD-L1(+) and mPD-L1(-) DLBCL (P = .31). The expression of PD-L1 maintained prognostic value for OS in multivariate analysis (P = .0323). This is the first report describing the clinicopathological features and outcomes of PD-L1(+) DLBCL. Immunotherapy targeting the PD-1/PD-L1 pathway should be considered in this distinct DLBCL subgroup.
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79
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Abstract
Cancers can evade the host immune system by inducing upregulation of immune inhibitory signals. Anti-programmed cell death-1 (PD-1) monoclonal antibodies block these inhibitory signals allowing the host to mount an immune response against malignant cells. This class of drugs is active in solid tumours, where upregulation of cell-surface PD-1 ligand proteins is nearly uniform. Because lymphoma is a malignancy of immune system cells, the role of the PD-1 pathway in these neoplasms is more complex. However, early clinical trials using PD-1 inhibitors have shown significant clinical activity in various subtypes of relapsed lymphoma. In this Review, we assess the scientific literature on the role of the PD-1 pathway in lymphoma, the relevant clinical data for PD-1 inhibition, and future strategies for this next generation of anticancer agents.
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Affiliation(s)
- Eliza A Hawkes
- Department of Medical Oncology and Clinical Haematology, Olivia Newton John Cancer and Wellness Centre, Austin Hospital, Melbourne, VIC, Australia; Department of Medical Oncology, Eastern Health, Melbourne, VIC Australia; Monash University, Melbourne, VIC, Australia.
| | - Andrew Grigg
- Department of Medical Oncology and Clinical Haematology, Olivia Newton John Cancer and Wellness Centre, Austin Hospital, Melbourne, VIC, Australia; University of Melbourne, Melbourne, VIC, Australia
| | - Geoff Chong
- Department of Medical Oncology and Clinical Haematology, Olivia Newton John Cancer and Wellness Centre, Austin Hospital, Melbourne, VIC, Australia; Department of Oncology, Northern Hospital, Melbourne, VIC, Australia; Department of Medical Oncology, Ballarat Health Services, Ballarat, VIC, Australia
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80
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Fend F, Quintanilla-Martínez L. Assessing the prognostic impact of immune cell infiltrates in follicular lymphoma. Haematologica 2015; 99:599-602. [PMID: 24688106 DOI: 10.3324/haematol.2014.104968] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
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81
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Laurent C, Charmpi K, Gravelle P, Tosolini M, Franchet C, Ysebaert L, Brousset P, Bidaut A, Ycart B, Fournié JJ. Several immune escape patterns in non-Hodgkin's lymphomas. Oncoimmunology 2015; 4:e1026530. [PMID: 26405585 PMCID: PMC4570141 DOI: 10.1080/2162402x.2015.1026530] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 02/27/2015] [Accepted: 02/27/2015] [Indexed: 12/31/2022] Open
Abstract
Follicular Lymphomas (FL) and diffuse large B cell lymphomas (DLBCL) must evolve some immune escape strategy to develop from lymphoid organs, but their immune evasion pathways remain poorly characterized. We investigated this issue by transcriptome data mining and immunohistochemistry (IHC) of FL and DLBCL lymphoma biopsies. A set of genes involved in cancer immune-evasion pathways (Immune Escape Gene Set, IEGS) was defined and the distribution of the expression levels of these genes was compared in FL, DLBCL and normal B cell transcriptomes downloaded from the GEO database. The whole IEGS was significantly upregulated in all the lymphoma samples but not in B cells or other control tissues, as shown by the overexpression of the PD-1, PD-L1, PD-L2 and LAG3 genes. Tissue microarray immunostainings for PD-1, PD-L1, PD-L2 and LAG3 proteins on additional biopsies from 27 FL and 27 DLBCL patients confirmed the expression of these proteins. The immune infiltrates were more abundant in FL than DLBCL samples, and the microenvironment of FL comprised higher rates of PD-1+ lymphocytes. Further, DLBCL tumor cells comprised a higher proportion of PD-1+, PD-L1+, PD-L2+ and LAG3+ lymphoma cells than the FL tumor cells, confirming that DLBCL mount immune escape strategies distinct from FL. In addition, some cases of DLBCL had tumor cells co-expressing both PD-1, PD-L1 and PD-L2. Among the DLBCLs, the activated B cell (ABC) subtype comprised more PD-L1+ and PD-L2+ lymphoma cells than the GC subtype. Thus, we infer that FL and DLBCL evolved several pathways of immune escape.
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Affiliation(s)
- Camille Laurent
- Institut Universitaire du Cancer-Oncopole de Toulouse ; Toulouse, France ; Centre de Recherches en Cancérologie de Toulouse; INSERM UMR1037 ; Toulouse, France ; Université Toulouse III Paul-Sabatier ; Toulouse, France ; ERL 5294 CNRS ; Toulouse, France ; Programme Hospitalo-Universitaire en Cancérologie CAPTOR ; Toulouse, France ; Institut Carnot Lymphome CALYM ; Toulouse, France ; Laboratoire d'Excellence 'TOUCAN' ; Toulouse, France
| | - Konstantina Charmpi
- Laboratoire d'Excellence 'TOUCAN' ; Toulouse, France ; Laboratoire Jean Kuntzmann; CNRS UMR5224 ; Grenoble, France
| | - Pauline Gravelle
- Institut Universitaire du Cancer-Oncopole de Toulouse ; Toulouse, France ; Centre de Recherches en Cancérologie de Toulouse; INSERM UMR1037 ; Toulouse, France ; Université Toulouse III Paul-Sabatier ; Toulouse, France ; ERL 5294 CNRS ; Toulouse, France ; Programme Hospitalo-Universitaire en Cancérologie CAPTOR ; Toulouse, France ; Institut Carnot Lymphome CALYM ; Toulouse, France ; Laboratoire d'Excellence 'TOUCAN' ; Toulouse, France
| | - Marie Tosolini
- Centre de Recherches en Cancérologie de Toulouse; INSERM UMR1037 ; Toulouse, France ; Université Toulouse III Paul-Sabatier ; Toulouse, France ; ERL 5294 CNRS ; Toulouse, France ; Programme Hospitalo-Universitaire en Cancérologie CAPTOR ; Toulouse, France ; Institut Carnot Lymphome CALYM ; Toulouse, France ; Laboratoire d'Excellence 'TOUCAN' ; Toulouse, France
| | - Camille Franchet
- Institut Universitaire du Cancer-Oncopole de Toulouse ; Toulouse, France
| | - Loïc Ysebaert
- Institut Universitaire du Cancer-Oncopole de Toulouse ; Toulouse, France ; Centre de Recherches en Cancérologie de Toulouse; INSERM UMR1037 ; Toulouse, France ; Université Toulouse III Paul-Sabatier ; Toulouse, France ; ERL 5294 CNRS ; Toulouse, France ; Programme Hospitalo-Universitaire en Cancérologie CAPTOR ; Toulouse, France ; Institut Carnot Lymphome CALYM ; Toulouse, France ; Laboratoire d'Excellence 'TOUCAN' ; Toulouse, France
| | - Pierre Brousset
- Institut Universitaire du Cancer-Oncopole de Toulouse ; Toulouse, France ; Centre de Recherches en Cancérologie de Toulouse; INSERM UMR1037 ; Toulouse, France ; Université Toulouse III Paul-Sabatier ; Toulouse, France ; ERL 5294 CNRS ; Toulouse, France ; Programme Hospitalo-Universitaire en Cancérologie CAPTOR ; Toulouse, France ; Institut Carnot Lymphome CALYM ; Toulouse, France ; Laboratoire d'Excellence 'TOUCAN' ; Toulouse, France
| | | | - Bernard Ycart
- Laboratoire d'Excellence 'TOUCAN' ; Toulouse, France ; Laboratoire Jean Kuntzmann; CNRS UMR5224 ; Grenoble, France
| | - Jean-Jacques Fournié
- Centre de Recherches en Cancérologie de Toulouse; INSERM UMR1037 ; Toulouse, France ; Université Toulouse III Paul-Sabatier ; Toulouse, France ; ERL 5294 CNRS ; Toulouse, France ; Programme Hospitalo-Universitaire en Cancérologie CAPTOR ; Toulouse, France ; Institut Carnot Lymphome CALYM ; Toulouse, France ; Laboratoire d'Excellence 'TOUCAN' ; Toulouse, France
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82
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Immune checkpoint blockade in hematologic malignancies. Blood 2015; 125:3393-400. [PMID: 25833961 DOI: 10.1182/blood-2015-02-567453] [Citation(s) in RCA: 180] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 03/25/2015] [Indexed: 02/07/2023] Open
Abstract
Therapeutic blockade of immune checkpoint pathways, in particular cytotoxic T-lymphocyte associated protein 4 and programmed-death 1 (PD-1), has become a paradigm-shifting treatment in solid tumor oncology. Hematologic malignancies (HMs), many of which are known to have clinically exploitable immune sensitivity, are a natural target for this type of treatment. Several clinical trials of checkpoint blockade have been conducted in HM, with preliminary results suggesting the therapeutic usefulness of this approach across several tumor types. In particular, the results of PD-1 blockade in Hodgkin lymphoma (HL) are remarkable, and raise hope that it may alter the treatment landscape in this disease. However, numerous questions remain about the optimal role of checkpoint blockade both in HL and beyond. Those questions are the focus of this review, in the hope that, if we are at the dawn of a new day in HM immunotherapy, we may begin to envision its morning.
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84
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Abstract
The diagnosis of B-cell non-Hodgkin lymphomas has changed significantly over the past few decades as new immunophenotypic markers, molecular subtype classification schemes, and novel biomarkers have emerged. Meanwhile, there has been an increasing emphasis on individualizing treatment approaches in accordance with a biologic heterogeneity that has been uncovered within many of the individual B-cell lymphoma entities. The application of high-throughput genomic sequencing to B-cell lymphomas has yielded large amounts of valuable information. The data encompass discoveries essential to an understanding of pathogenesis, clonal or tumoral evolution, and identification of biomarkers that may be useful for prognostic or therapeutic considerations. The following review discusses several of the more common, primarily tissuebased B-cell lymphomas, with a focus on pathologic classification and certain phenotypic characteristics or genetic lesions that apply to refinement of diagnosis and therapy.
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MESH Headings
- Biomarkers, Tumor
- High-Throughput Nucleotide Sequencing
- Humans
- Lymphoma, B-Cell/diagnosis
- Lymphoma, B-Cell/genetics
- Lymphoma, B-Cell/pathology
- Lymphoma, Follicular/diagnosis
- Lymphoma, Follicular/genetics
- Lymphoma, Follicular/pathology
- Lymphoma, Mantle-Cell/diagnosis
- Lymphoma, Mantle-Cell/genetics
- Lymphoma, Mantle-Cell/pathology
- Mutation
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Affiliation(s)
- Sarah L Ondrejka
- Cleveland Clinic-Robert J. Tomsich Pathology and Laboratory Medicine Institute, 9500 Euclid Ave, L3, Cleveland, OH, 44195, USA
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85
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Coutinho R, Clear AJ, Mazzola E, Owen A, Greaves P, Wilson A, Matthews J, Lee A, Alvarez R, da Silva MG, Cabeçadas J, Neuberg D, Calaminici M, Gribben JG. Revisiting the immune microenvironment of diffuse large B-cell lymphoma using a tissue microarray and immunohistochemistry: robust semi-automated analysis reveals CD3 and FoxP3 as potential predictors of response to R-CHOP. Haematologica 2014; 100:363-9. [PMID: 25425693 DOI: 10.3324/haematol.2014.110189] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Gene expression studies have identified the microenvironment as a prognostic player in diffuse large B-cell lymphoma. However, there is a lack of simple immune biomarkers that can be applied in the clinical setting and could be helpful in stratifying patients. Immunohistochemistry has been used for this purpose but the results are inconsistent. We decided to reinvestigate the immune microenvironment and its impact using immunohistochemistry, with two systems of image analysis, in a large set of patients with diffuse large B-cell lymphoma. Diagnostic tissue from 309 patients was arrayed onto tissue microarrays. Results from 161 chemoimmunotherapy-treated patients were used for outcome prediction. Positive cells, percentage stained area and numbers of pixels/area were quantified and results were compared with the purpose of inferring consistency between the two semi-automated systems. Measurement cutpoints were assessed using a recursive partitioning algorithm classifying results according to survival. Kaplan-Meier estimators and Fisher exact tests were evaluated to check for significant differences between measurement classes, and for dependence between pairs of measurements, respectively. Results were validated by multivariate analysis incorporating the International Prognostic Index. The concordance between the two systems of image analysis was surprisingly high, supporting their applicability for immunohistochemistry studies. Patients with a high density of CD3 and FoxP3 by both methods had a better outcome. Automated analysis should be the preferred method for immunohistochemistry studies. Following the use of two methods of semi-automated analysis we suggest that CD3 and FoxP3 play a role in predicting response to chemoimmunotherapy in diffuse large B-cell lymphoma.
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Affiliation(s)
- Rita Coutinho
- Department of Hemato-Oncology, Barts Cancer Institute, Queen Mary University, London, UK
| | - Andrew J Clear
- Department of Hemato-Oncology, Barts Cancer Institute, Queen Mary University, London, UK
| | - Emanuele Mazzola
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Andrew Owen
- Department of Hemato-Oncology, Barts Cancer Institute, Queen Mary University, London, UK Department of Histopathology, Barts Health NHS Trust, Royal London Hospital, UK
| | - Paul Greaves
- Department of Hemato-Oncology, Barts Cancer Institute, Queen Mary University, London, UK
| | - Andrew Wilson
- Department of Hemato-Oncology, Barts Cancer Institute, Queen Mary University, London, UK
| | - Janet Matthews
- Department of Hemato-Oncology, Barts Cancer Institute, Queen Mary University, London, UK
| | - Abigail Lee
- Department of Hemato-Oncology, Barts Cancer Institute, Queen Mary University, London, UK Department of Histopathology, Barts Health NHS Trust, Royal London Hospital, UK
| | - Rute Alvarez
- Department of Hematology, Portuguese Institute of Oncology, Lisbon, Portugal
| | | | - José Cabeçadas
- Department of Pathology, Portuguese Institute of Oncology, Lisbon, Portugal
| | - Donna Neuberg
- Department of Histopathology, Barts Health NHS Trust, Royal London Hospital, UK
| | - Maria Calaminici
- Department of Hemato-Oncology, Barts Cancer Institute, Queen Mary University, London, UK Department of Histopathology, Barts Health NHS Trust, Royal London Hospital, UK
| | - John G Gribben
- Department of Hemato-Oncology, Barts Cancer Institute, Queen Mary University, London, UK
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Nygren L, Wasik AM, Baumgartner-Wennerholm S, Jeppsson-Ahlberg Å, Klimkowska M, Andersson P, Buhrkuhl D, Christensson B, Kimby E, Wahlin BE, Sander B. T-Cell Levels Are Prognostic in Mantle Cell Lymphoma. Clin Cancer Res 2014; 20:6096-104. [DOI: 10.1158/1078-0432.ccr-14-0889] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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87
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Xerri L, Bachy E, Fabiani B, Canioni D, Chassagne-Clément C, Dartigues-Cuilléres P, Charlotte F, Brousse N, Rousselet MC, Foussard C, Brice P, Feugier P, Morschhauser F, Sonet A, Olive D, Salles G. Identification of MUM1 as a prognostic immunohistochemical marker in follicular lymphoma using computerized image analysis. Hum Pathol 2014; 45:2085-93. [DOI: 10.1016/j.humpath.2014.06.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 06/17/2014] [Accepted: 06/25/2014] [Indexed: 12/22/2022]
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Kedmi M, Avigdor A, Nagler A. Anti-PD-1-targeted therapies focusing on lymphatic malignancies: biological rationale, clinical challenges and opportunities. Acta Haematol 2014; 133:129-35. [PMID: 25247668 DOI: 10.1159/000362151] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2014] [Accepted: 03/09/2014] [Indexed: 01/01/2023]
Abstract
Cancer immunotherapy with tumor-directed antibodies has generally been very successful, while T-cell immunotherapy has been less effective. Some lymphoid malignancies can be cured with immunochemotherapy but nevertheless many patients relapse or progress in spite of maximal therapy. Both solid tumors and lymphoid malignancies develop mechanisms in order to escape destruction by the intact immune system. One such mechanism is mediated through immune checkpoints. PD-1 (programmed cell death protein-1, which is expressed on activated T and B cells, natural killer cells and myeloid cells, is one of those checkpoints. This review focuses on the effect of PD-1 activation on lymphoid malignancies and its role as a therapeutic target.
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Affiliation(s)
- Meirav Kedmi
- Hematology Division, Chaim Sheba Medical Center, Tel Hashomer, and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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89
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Pinheiro D, Chang YM, Bryant H, Szladovits B, Dalessandri T, Davison LJ, Yallop E, Mills E, Leo C, Lara A, Stell A, Polton G, Garden OA. Dissecting the regulatory microenvironment of a large animal model of non-Hodgkin lymphoma: evidence of a negative prognostic impact of FOXP3+ T cells in canine B cell lymphoma. PLoS One 2014; 9:e105027. [PMID: 25119018 PMCID: PMC4132014 DOI: 10.1371/journal.pone.0105027] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Accepted: 07/19/2014] [Indexed: 02/06/2023] Open
Abstract
The cancer microenvironment plays a pivotal role in oncogenesis, containing a number of regulatory cells that attenuate the anti-neoplastic immune response. While the negative prognostic impact of regulatory T cells (Tregs) in the context of most solid tissue tumors is well established, their role in lymphoid malignancies remains unclear. T cells expressing FOXP3 and Helios were documented in the fine needle aspirates of affected lymph nodes of dogs with spontaneous multicentric B cell lymphoma (BCL), proposed to be a model for human non-Hodgkin lymphoma. Multivariable analysis revealed that the frequency of lymph node FOXP3+ T cells was an independent negative prognostic factor, impacting both progression-free survival (hazard ratio 1.10; p = 0.01) and overall survival (hazard ratio 1.61; p = 0.01) when comparing dogs showing higher than the median FOXP3 expression with those showing the median value of FOXP3 expression or less. Taken together, these data suggest the existence of a population of Tregs operational in canine multicentric BCL that resembles thymic Tregs, which we speculate are co-opted by the tumor from the periphery. We suggest that canine multicentric BCL represents a robust large animal model of human diffuse large BCL, showing clinical, cytological and immunophenotypic similarities with the disease in man, allowing comparative studies of immunoregulatory mechanisms.
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Affiliation(s)
- Dammy Pinheiro
- Department of Clinical Sciences and Services, Immune Regulation Laboratory, The Royal Veterinary College, London, United Kingdom
| | - Yu-Mei Chang
- Research Office, The Royal Veterinary College, London, United Kingdom
| | - Hannah Bryant
- Department of Clinical Sciences and Services, Immune Regulation Laboratory, The Royal Veterinary College, London, United Kingdom
| | - Balazs Szladovits
- Department of Pathology and Pathogen Biology, The Royal Veterinary College, Hatfield, Hertfordshire, United Kingdom
| | - Tim Dalessandri
- Department of Clinical Sciences and Services, Immune Regulation Laboratory, The Royal Veterinary College, London, United Kingdom
| | - Lucy J. Davison
- Henry Wellcome Building, Centre for Cellular and Molecular Physiology, University of Oxford, Oxford, United Kingdom
- Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Elizabeth Yallop
- Clinical Investigation Centre, The Royal Veterinary College, Hatfield, Hertfordshire, United Kingdom
| | - Emily Mills
- Clinical Investigation Centre, The Royal Veterinary College, Hatfield, Hertfordshire, United Kingdom
| | - Chiara Leo
- Department of Clinical Sciences and Services, Queen Mother Hospital for Animals, The Royal Veterinary College, Hatfield, Hertfordshire, United Kingdom
| | - Ana Lara
- Department of Clinical Sciences and Services, Queen Mother Hospital for Animals, The Royal Veterinary College, Hatfield, Hertfordshire, United Kingdom
| | - Anneliese Stell
- Department of Clinical Sciences and Services, Queen Mother Hospital for Animals, The Royal Veterinary College, Hatfield, Hertfordshire, United Kingdom
| | - Gerry Polton
- Oncology Service, North Downs Specialist Referrals, Bletchingley, Surrey, United Kingdom
| | - Oliver A. Garden
- Department of Clinical Sciences and Services, Immune Regulation Laboratory, The Royal Veterinary College, London, United Kingdom
- Department of Clinical Sciences and Services, Queen Mother Hospital for Animals, The Royal Veterinary College, Hatfield, Hertfordshire, United Kingdom
- * E-mail:
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90
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Nesterova ES, Kravchenko SK, Gemdjian EG, Osmanov EA, Kovrigina AM. Tumor-associated cytotoxic lymphocytes and macrophages as predictive factors in follicular lymphoma. BIOCHEMISTRY (MOSCOW) SUPPLEMENT SERIES A: MEMBRANE AND CELL BIOLOGY 2014. [DOI: 10.1134/s1990747813050127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Spolski R, Leonard WJ. Interleukin-21: a double-edged sword with therapeutic potential. Nat Rev Drug Discov 2014; 13:379-95. [PMID: 24751819 DOI: 10.1038/nrd4296] [Citation(s) in RCA: 396] [Impact Index Per Article: 39.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Interleukin-21 is a cytokine with broad pleiotropic actions that affect the differentiation and function of lymphoid and myeloid cells. Since its discovery in 2000, a tremendous amount has been learned about its biological actions and the molecular mechanisms controlling IL-21-mediated cellular responses. IL-21 regulates both innate and adaptive immune responses, and it not only has key roles in antitumour and antiviral responses but also exerts major effects on inflammatory responses that promote the development of autoimmune diseases and inflammatory disorders. Numerous studies have shown that enhancing or inhibiting the action of IL-21 has therapeutic effects in animal models of a wide range of diseases, and various clinical trials are underway. The current challenge is to understand how to specifically modulate the actions of IL-21 in the context of each specific immune response or pathological situation. In this Review, we provide an overview of the basic biology of IL-21 and discuss how this information has been - and can be - exploited therapeutically.
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Affiliation(s)
- Rosanne Spolski
- Laboratory of Molecular Immunology, National Heart, Lung, and Blood Institute (NHLBI), US National Institutes of Health, Bethesda, Maryland 20892, USA
| | - Warren J Leonard
- Laboratory of Molecular Immunology, National Heart, Lung, and Blood Institute (NHLBI), US National Institutes of Health, Bethesda, Maryland 20892, USA
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Smeltzer JP, Jones JM, Ziesmer SC, Grote DM, Xiu B, Ristow KM, Yang ZZ, Nowakowski GS, Feldman AL, Cerhan JR, Novak AJ, Ansell SM. Pattern of CD14+ follicular dendritic cells and PD1+ T cells independently predicts time to transformation in follicular lymphoma. Clin Cancer Res 2014; 20:2862-72. [PMID: 24727328 DOI: 10.1158/1078-0432.ccr-13-2367] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
PURPOSE Transformation of follicular lymphoma is a critical event associated with a poor prognosis. The role of the tumor microenvironment in previous transformation studies has yielded conflicting results. EXPERIMENTAL DESIGN To define cell subtypes associated with transformation, we examined tissue specimens at diagnosis from patients with follicular lymphoma that later transformed and, using immunohistochemistry (IHC), stained for CD68, CD11c, CD21, CXCL13, FOXP3, PD1, and CD14. Cell content and the pattern of expression were evaluated. Those identified as significantly associated with time to transformation (TTT) and overall survival (OS) were further characterized by flow cytometry and multicolor IHC. RESULTS Of note, 58 patients were analyzed with median TTT of 4.7 years. The pattern of PD1(+) and CD14(+) cells rather than the quantity of cells was predictive of clinical outcomes. On multivariate analysis, including the follicular lymphoma international prognostic index score, CD14(+) cells localized in the follicle were associated with a shorter TTT (HR, 3.0; P = 0.004). PD1(+) cells with diffuse staining were associated with a shorter TTT (HR, 1.9; P = 0.045) and inferior OS (HR, 2.5; P = 0.012). Multicolor IHC and flow cytometry identified CD14(+) cells as follicular dendritic cells (FDC), whereas PD1(+) cells represented two separate populations, TFH and exhausted T cells. CONCLUSION These results identify the presence of PD1(+) T cells and CD14(+) FDC as independent predictors of transformation in follicular lymphoma. Clin Cancer Res; 20(11); 2862-72. ©2014 AACR.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor/analysis
- Biomarkers, Tumor/immunology
- Biomarkers, Tumor/metabolism
- Cell Transformation, Neoplastic/immunology
- Cell Transformation, Neoplastic/metabolism
- Cell Transformation, Neoplastic/pathology
- Dendritic Cells, Follicular/immunology
- Dendritic Cells, Follicular/metabolism
- Dendritic Cells, Follicular/pathology
- Female
- Humans
- Immunohistochemistry
- Kaplan-Meier Estimate
- Lipopolysaccharide Receptors/immunology
- Lipopolysaccharide Receptors/metabolism
- Lymphoma, Follicular/immunology
- Lymphoma, Follicular/mortality
- Lymphoma, Follicular/pathology
- Male
- Middle Aged
- Prognosis
- Programmed Cell Death 1 Receptor/immunology
- Programmed Cell Death 1 Receptor/metabolism
- Proportional Hazards Models
- T-Lymphocytes/immunology
- T-Lymphocytes/metabolism
- T-Lymphocytes/pathology
- Tumor Microenvironment/immunology
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Affiliation(s)
- Jacob P Smeltzer
- Authors' Affiliations: Division of Hematology; Division of Epidemiology; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota; and Department of Hematology, Tongji Hospital, Tongji University, Shanghai, China
| | - Jason M Jones
- Authors' Affiliations: Division of Hematology; Division of Epidemiology; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota; and Department of Hematology, Tongji Hospital, Tongji University, Shanghai, China
| | - Steven C Ziesmer
- Authors' Affiliations: Division of Hematology; Division of Epidemiology; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota; and Department of Hematology, Tongji Hospital, Tongji University, Shanghai, China
| | - Deanna M Grote
- Authors' Affiliations: Division of Hematology; Division of Epidemiology; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota; and Department of Hematology, Tongji Hospital, Tongji University, Shanghai, China
| | - Bing Xiu
- Authors' Affiliations: Division of Hematology; Division of Epidemiology; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota; and Department of Hematology, Tongji Hospital, Tongji University, Shanghai, China
| | - Kay M Ristow
- Authors' Affiliations: Division of Hematology; Division of Epidemiology; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota; and Department of Hematology, Tongji Hospital, Tongji University, Shanghai, China
| | - Zhi Zhang Yang
- Authors' Affiliations: Division of Hematology; Division of Epidemiology; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota; and Department of Hematology, Tongji Hospital, Tongji University, Shanghai, China
| | - Grzegorz S Nowakowski
- Authors' Affiliations: Division of Hematology; Division of Epidemiology; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota; and Department of Hematology, Tongji Hospital, Tongji University, Shanghai, China
| | - Andrew L Feldman
- Authors' Affiliations: Division of Hematology; Division of Epidemiology; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota; and Department of Hematology, Tongji Hospital, Tongji University, Shanghai, China
| | - James R Cerhan
- Authors' Affiliations: Division of Hematology; Division of Epidemiology; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota; and Department of Hematology, Tongji Hospital, Tongji University, Shanghai, China
| | - Anne J Novak
- Authors' Affiliations: Division of Hematology; Division of Epidemiology; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota; and Department of Hematology, Tongji Hospital, Tongji University, Shanghai, China
| | - Stephen M Ansell
- Authors' Affiliations: Division of Hematology; Division of Epidemiology; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota; and Department of Hematology, Tongji Hospital, Tongji University, Shanghai, China
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93
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Nam SJ, Go H, Paik JH, Kim TM, Heo DS, Kim CW, Jeon YK. An increase of M2 macrophages predicts poor prognosis in patients with diffuse large B-cell lymphoma treated with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone. Leuk Lymphoma 2014; 55:2466-76. [DOI: 10.3109/10428194.2013.879713] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Soo Jeong Nam
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine,
Seoul, Korea
- The Tumor Immunity Medical Research Center, Cancer Research Center, Seoul National University College of Medicine,
Seoul, Korea
| | - Heounjeong Go
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine,
Seoul, Korea
- The Tumor Immunity Medical Research Center, Cancer Research Center, Seoul National University College of Medicine,
Seoul, Korea
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine,
Seoul, Korea
| | - Jin Ho Paik
- Department of Pathology, Seoul National University Bundang Hospital,
Seongnam-si, Korea
| | - Tae Min Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine,
Seoul, Korea
| | - Dae Seog Heo
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine,
Seoul, Korea
| | - Chul Woo Kim
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine,
Seoul, Korea
- The Tumor Immunity Medical Research Center, Cancer Research Center, Seoul National University College of Medicine,
Seoul, Korea
| | - Yoon Kyung Jeon
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine,
Seoul, Korea
- The Tumor Immunity Medical Research Center, Cancer Research Center, Seoul National University College of Medicine,
Seoul, Korea
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94
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Sander B, de Jong D, Rosenwald A, Xie W, Balagué O, Calaminici M, Carreras J, Gaulard P, Gribben J, Hagenbeek A, Kersten MJ, Molina TJ, Lee A, Montes-Moreno S, Ott G, Raemaekers J, Salles G, Sehn L, Thorns C, Wahlin BE, Gascoyne RD, Weller E. The reliability of immunohistochemical analysis of the tumor microenvironment in follicular lymphoma: a validation study from the Lunenburg Lymphoma Biomarker Consortium. Haematologica 2014; 99:715-25. [PMID: 24510338 DOI: 10.3324/haematol.2013.095257] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
The cellular microenvironment in follicular lymphoma is of biological and clinical importance. Studies on the clinical significance of non-malignant cell populations have generated conflicting results, which may partly be influenced by poor reproducibility in immunohistochemical marker quantification. In this study, the reproducibility of manual scoring and automated microscopy based on a tissue microarray of 25 follicular lymphomas as compared to flow cytometry is evaluated. The agreement between manual scoring and flow cytometry was moderate for CD3, low for CD4, and moderate to high for CD8, with some laboratories scoring closer to the flow cytometry results. Agreement in manual quantification across the 7 laboratories was low to moderate for CD3, CD4, CD8 and FOXP3 frequencies, moderate for CD21, low for MIB1 and CD68, and high for CD10. Manual scoring of the architectural distribution resulted in moderate agreement for CD3, CD4 and CD8, and low agreement for FOXP3 and CD68. Comparing manual scoring to automated microscopy demonstrated that manual scoring increased the variability in the low and high frequency interval with some laboratories showing a better agreement with automated scores. Manual scoring reliably identified rare architectural patterns of T-cell infiltrates. Automated microscopy analyses for T-cell markers by two different instruments were highly reproducible and provided acceptable agreement with flow cytometry. These validation results provide explanations for the heterogeneous findings on the prognostic value of the microenvironment in follicular lymphoma. We recommend a more objective measurement, such as computer-assisted scoring, in future studies of the prognostic impact of microenvironment in follicular lymphoma patients.
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95
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Merelli B, Massi D, Cattaneo L, Mandalà M. Targeting the PD1/PD-L1 axis in melanoma: Biological rationale, clinical challenges and opportunities. Crit Rev Oncol Hematol 2014; 89:140-65. [DOI: 10.1016/j.critrevonc.2013.08.002] [Citation(s) in RCA: 104] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 08/10/2013] [Accepted: 08/15/2013] [Indexed: 12/16/2022] Open
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96
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Westin JR, Chu F, Zhang M, Fayad LE, Kwak LW, Fowler N, Romaguera J, Hagemeister F, Fanale M, Samaniego F, Feng L, Baladandayuthapani V, Wang Z, Ma W, Gao Y, Wallace M, Vence LM, Radvanyi L, Muzzafar T, Rotem-Yehudar R, Davis RE, Neelapu SS. Safety and activity of PD1 blockade by pidilizumab in combination with rituximab in patients with relapsed follicular lymphoma: a single group, open-label, phase 2 trial. Lancet Oncol 2013; 15:69-77. [PMID: 24332512 DOI: 10.1016/s1470-2045(13)70551-5] [Citation(s) in RCA: 433] [Impact Index Per Article: 39.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Endogenous or iatrogenic antitumour immune responses can improve the course of follicular lymphoma, but might be diminished by immune checkpoints in the tumour microenvironment. These checkpoints might include effects of programmed cell death 1 (PD1), a co-inhibitory receptor that impairs T-cell function and is highly expressed on intratumoral T cells. We did this phase 2 trial to investigate the activity of pidilizumab, a humanised anti-PD1 monoclonal antibody, with rituximab in patients with relapsed follicular lymphoma. METHODS We did this open-label, non-randomised trial at the University of Texas MD Anderson Cancer Center (Houston, TX, USA). Adult (≥18 years) patients with rituximab-sensitive follicular lymphoma relapsing after one to four previous therapies were eligible. Pidilizumab was administered at 3 mg/kg intravenously every 4 weeks for four infusions, plus eight optional infusions every 4 weeks for patients with stable disease or better. Starting 17 days after the first infusion of pidilizumab, rituximab was given at 375 mg/m(2) intravenously weekly for 4 weeks. The primary endpoint was the proportion of patients who achieved an objective response (complete response plus partial response according to Revised Response Criteria for Malignant Lymphoma). Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00904722. FINDINGS We enrolled 32 patients between Jan 13, 2010, and Jan 20, 2012. Median follow-up was 15.4 months (IQR 10.1-21.0). The combination of pidilizumab and rituximab was well tolerated, with no autoimmune or treatment-related adverse events of grade 3 or 4. The most common adverse events of grade 1 were anaemia (14 patients) and fatigue (13 patients), and the most common adverse event of grade 2 was respiratory infection (five patients). Of the 29 patients evaluable for activity, 19 (66%) achieved an objective response: complete responses were noted in 15 (52%) patients and partial responses in four (14%). INTERPRETATION The combination of pidilizumab plus rituximab is well tolerated and active in patients with relapsed follicular lymphoma. Our results suggest that immune checkpoint blockade is worthy of further study in follicular lymphoma. FUNDING National Institutes of Health, Leukemia and Lymphoma Society, Cure Tech, and University of Texas MD Anderson Cancer Center.
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Affiliation(s)
- Jason R Westin
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Fuliang Chu
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Center for Cancer Immunology Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Min Zhang
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Center for Cancer Immunology Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Luis E Fayad
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Larry W Kwak
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Center for Cancer Immunology Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Nathan Fowler
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jorge Romaguera
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Fredrick Hagemeister
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michelle Fanale
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Felipe Samaniego
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lei Feng
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Zhiqiang Wang
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Center for Cancer Immunology Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Wencai Ma
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Center for Cancer Immunology Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Yanli Gao
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michael Wallace
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Luis M Vence
- Center for Cancer Immunology Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Laszlo Radvanyi
- Center for Cancer Immunology Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Tariq Muzzafar
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - R Eric Davis
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Center for Cancer Immunology Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sattva S Neelapu
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Center for Cancer Immunology Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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97
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Mitteldorf C, Bieri M, Wey N, Kerl K, Kamarachev J, Pfaltz M, Kutzner H, Roncador G, Tomasini D, Kempf W. Expression of programmed death-1 (CD279) in primary cutaneous B-cell lymphomas with correlation to lymphoma entities and biological behaviour. Br J Dermatol 2013; 169:1212-8. [DOI: 10.1111/bjd.12579] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2013] [Indexed: 12/12/2022]
Affiliation(s)
- C. Mitteldorf
- Department of Dermatology; Klinikum Hildesheim GmbH; Hildesheim Germany
| | - M. Bieri
- Department of Pathology; University Hospital Zürich; Zürich Switzerland
| | - N. Wey
- Department of Pathology; University Hospital Zürich; Zürich Switzerland
| | - K. Kerl
- Department of Dermatology; University Hospital Zürich; Zürich Switzerland
| | - J. Kamarachev
- Department of Dermatology; University Hospital Zürich; Zürich Switzerland
| | - M. Pfaltz
- Department of Psychiatry and Psychotherapy; University Hospital Zürich; Zürich Switzerland
- Kempf und Pfaltz; Histologische Diagnostik; Research Unit; Seminarstrasse 1 CH-8042 Zürich Switzerland
| | - H. Kutzner
- Dermatopathologie Friedrichshafen Bodensee; Friedrichshafen Germany
| | - G. Roncador
- Centro Nacional de Investigaciones Oncologicas; Madrid Spain
| | - D. Tomasini
- Department of Dermatology; Hospital of Busto Arsizio; Busto Arsizio Italy
| | - W. Kempf
- Department of Dermatology; University Hospital Zürich; Zürich Switzerland
- Kempf und Pfaltz; Histologische Diagnostik; Research Unit; Seminarstrasse 1 CH-8042 Zürich Switzerland
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98
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Çetinözman F, Koens L, Jansen PM, Willemze R. Programmed death-1 expression in cutaneous B-cell lymphoma. J Cutan Pathol 2013; 41:14-21. [PMID: 24151955 DOI: 10.1111/cup.12254] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 09/23/2013] [Accepted: 10/10/2013] [Indexed: 01/11/2023]
Abstract
BACKGROUND Numbers of programmed death-1 (PD-1) positive T cells have prognostic significance in some types of nodal B-cell lymphomas, but data on PD-1 expression in cutaneous B-cell lymphoma (CBCL) are few. In this study we determined the expression and distribution of PD-1 on neoplastic B cells and reactive T cells in skin sections from primary CBCLs. METHODS By means of immunohistochemical staining, PD-1 expression was investigated in skin biopsies from 10 patients with primary cutaneous marginal zone lymphoma (PCMZL), 18 patients with primary cutaneous follicle center lymphoma (PCFCL) and 12 patients with primary cutaneous diffuse large B-cell lymphoma-leg type (PCDLBCL-LT). RESULTS Neoplastic B cells were negative for PD-1 in all cases, except for two cases of PCDLBCL-LT. The frequency of PD-1(+) T cells was significantly higher in PCFCL than in PCMZL and PCDLBCL-LT, accounting for 20, 10 and 3% of the total number of infiltrating cells, and 60, 20 and 15% of the total number of CD3(+) T cells, respectively. CONCLUSIONS PD-1 is rarely expressed by the neoplastic B cells in CBCL. High percentages of PD-1(+) T cells, particularly if found outside germinal centers, support a diagnosis of PCFCL.
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Affiliation(s)
- Fatma Çetinözman
- Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands
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99
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von Hohenstaufen KA, Conconi A, de Campos CP, Franceschetti S, Bertoni F, Margiotta Casaluci G, Stathis A, Ghielmini M, Stussi G, Cavalli F, Gaidano G, Zucca E. Prognostic impact of monocyte count at presentation in mantle cell lymphoma. Br J Haematol 2013; 162:465-73. [PMID: 23808798 DOI: 10.1111/bjh.12409] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 05/02/2013] [Indexed: 11/29/2022]
Abstract
An increased number of circulating monocytes at presentation has recently been associated with shorter survival in Hodgkin lymphoma, follicular lymphoma and diffuse large B cell lymphoma. This study aimed to assess the prognostic impact of the absolute monocyte count (AMC) at diagnosis in mantle cell lymphoma (MCL). AMC at diagnosis was available in 97 MCL cases recorded in the databases of the Oncology Institute of Southern Switzerland in Bellinzona (Switzerland) and the Division of Haematology of the Amedeo Avogadro University of Eastern Piedmont in Novara (Italy). With a median follow up of 7 years, the 5-year overall survival was 29% for patients with AMC >0·50 × 10(9) /l and 62% for patients with AMC ≤0·50 × 10(9) /l (P = 0·008). Elevated AMC and beta-2 microglobulin at diagnosis remained independent outcome predictors at multivariate analysis, controlling for the MCL International Prognostic Index (MIPI), and have been used to build a simple prognostic scoring system. In this relatively small and heterogeneous series an increased AMC identified poor-risk patients. Our results suggest that AMC together with the beta-2 microglobulin level might provide an inexpensive way to stratify MCL patient risk as a complement to the MIPI, which was confirmed to be a very powerful prognostic tool.
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100
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Głowala-Kosińska M, Chwieduk A, Nieckula J, Saduś-Wojciechowska M, Grosicki S, Rusin A, Nowara E, Giebel S. Association of circulating regulatory T cell number with the incidence and prognosis of diffuse large B-cell lymphoma. Eur J Haematol 2013; 91:122-8. [DOI: 10.1111/ejh.12144] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2013] [Indexed: 12/21/2022]
Affiliation(s)
- Magdalena Głowala-Kosińska
- Department of Bone Marrow Transplantation; Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology; Gliwice; Poland
| | - Agata Chwieduk
- Department of Bone Marrow Transplantation; Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology; Gliwice; Poland
| | - Jarosław Nieckula
- Department of Clinical and Experimental Oncology; Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology; Gliwice; Poland
| | - Maria Saduś-Wojciechowska
- Department of Bone Marrow Transplantation; Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology; Gliwice; Poland
| | | | - Aleksandra Rusin
- Center for Translational Research and Molecular Biology of Cancer; Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology; Gliwice; Poland
| | - Elżbieta Nowara
- Department of Clinical and Experimental Oncology; Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology; Gliwice; Poland
| | - Sebastian Giebel
- Department of Bone Marrow Transplantation; Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology; Gliwice; Poland
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