scholarly journals Infiltration of Effector Regulatory T Cells Is Associated with Poor Prognosis in Diffuse Large B-Cell Lymphoma, Not Otherwise Specified

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 3884-3884
Author(s):  
Nakayama Shoko ◽  
Tsuji Motomu ◽  
Yokote Taiji ◽  
Akioka Toshikazu ◽  
Miyoshi Takuji ◽  
...  

Abstract (Background) Regulatory T cells (Tregs) are the focus of interest as one of the tumor microenvironmental factors because of their critical role in the modification of immune response, such as suppression of tumor-associated antigen-reactive lymphocytes. Tregs-mediated immunosuppression contributes to the progression of tumors and poor prognosis of patients. Forkhead box P3 (FOXP3) had been regarded as a specific marker of Tregs, but recently, FOXP3-positive cells were proved to be heterogeneous in phenotype and function. FOXP3-positive cells include effector Tregs (eTregs), naïve Tregs, and non-Tregs. Of them, eTregs have a substantial immunosuppressive effect. So far, no study has investigated the relationship between infiltration of eTregs and prognosis of patients with lymphoma. (Aim) The present study aimed to evaluate the relationship between infiltration of eTregs doubly positive for FOXP3/cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) and prognosis of patients with diffuse large B-cell lymphoma, not otherwise specified (DLBCL, NOS). (Methods) Seventy-four DLBCL, NOS specimens were doubly immunostained with anti-FOXP3 and anti-CTLA-4 antibodies. The relationship between the degree of infiltration of only FOXP3-positive cells or FOXP3/CTLA-4 double-positive eTregs and the prognosis of DLBCL, NOS patients was analyzed using Cox regression analysis. (Results) Presence of numerous FOXP3-positive cells (>52x102/cm2) was significantly predictive of better prognosis than that of fewer FOXP3-positive cells (<52x102/cm2) in terms of overall survival (OS) (p =0.0481) (Figure 1). In contrast, presence of many eTregs (>18/cm2) was significantly predictive of worse prognosis than that of fewer eTregs (<18/cm2) in terms of OS and progression-free survival (p =0.0342 and p =0.0269, respectively) (Figure 2). This was independent of the international prognostic index. (Conclusions) Higher infiltration of only FOXP3-positive cells showed better prognosis of DLBCL, NOS patients, consistent with existing reports. In contrast, higher infiltration of eTregs showed worse prognosis of DLBCL, NOS. This suggests that infiltrating eTregs play an important role in DLBCL, NOS progression. Recently, immunotherapies targeting eTregs-depletion or functional alteration of eTregs-are being developed and are being tried in some solid tumors. These immunotherapies could also become a novel strategy of treatment for DLBCL, NOS patients with higher eTregs infiltration. Figure 1. Figure 1. Figure 2. Figure 2. Disclosures Shoko: Osaka Community Foundation: Research Funding.

2014 ◽  
Vol 38 (8) ◽  
pp. 1138-1146 ◽  
Author(s):  
Shoko Nakayama ◽  
Taiji Yokote ◽  
Motomu Tsuji ◽  
Toshikazu Akioka ◽  
Takuji Miyoshi ◽  
...  

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 5288-5288
Author(s):  
Anthony P Lam ◽  
Bruce E Petersen ◽  
Ira Braunschweig ◽  
Howard Ratech

Abstract Introduction: Among patients with diffuse large B-cell lymphoma (DLBCL), it is well documented that for unknown reasons men have shorter progression-free and overall survival than women. Recently, a specialized subset of CD4+ T-cells, called regulatory T-cells (T-regs), which can suppress the effector functions of cytotoxic CD8+ T-cells, has been proposed to have a role in controlling tumor progression. While elevated T-regs in animal models of cancer can block anti-tumor responses and thereby enhance tumor growth, paradoxically, high T-regs are associated with improved survival in humans with DLBCL. To our knowledge, the relationship between T-regs and gender has not been investigated. Since T-regs constitutively express FoxP3, a transcription factor of the forkhead family, we used this marker to retrospectively study the number and density of FoxP3+ T-regs in tissue sections from both male and female patients with DLBCL, and to compare their effects on survival. Methods: Tumor microarrays of DLBCL containing three 1 mm diameter cores per patient were immunohistochemically stained for FoxP3 and CD4. We enumerated tumor infiltrating FoxP3+ lymphocytes by counting positive nuclei that crossed the lines of a 1 mm2 10×10 grid in a 10× ocular that was combined with a 40× objective in a BX41 Olympus microscope. The mean FoxP3 T-regs per field and the ratio of FoxP3 T-regs to total CD4+ T-cells were compared between 34 men and 48 women with de novo, non-AIDS related DLBCL. The median values were used as cut-offs for total FoxP3 counts and for FoxP3/CD4 ratios. We analyzed survival differences between “high” and “low” groups by using Kaplan-Meier curves and Logrank tests. Cox regression analyses were used to compare mortality after adjusting for age and staging. Results: Men had lower values than women both for mean total FoxP3 counts (7.05 vs 8.15, p=0.636) and for mean FoxP3/CD4 ratios (0.31 vs 0.51, p=0.183). Differences between genders in the proportion above the overall median (“high” group) were statistically significant when comparing total FoxP3 counts (32.4% in men vs. 60.4% in women, p=0.012) and FoxP3/CD4 ratios (35.3% vs. 58.3%, p=0.040). Using gender-specific cut-offs, higher FoxP3/CD4 ratios were associated with worse overall survival in men (Figure 1, p=0.052), but improved overall survival in women (Figure 2, p=0.047). The crude hazard ratio comparing groups with gender-specific “high” vs. “low” FoxP3/CD4 ratios was 3.99 (p=0.077) in men and 0.33 (p=0.061) in women. Adjusting for age did not result in significant changes, but adjusting for stage at diagnosis shifted the hazard ratios toward the null (1.06, p=0.947 in men and 0.45, p=0.218 in women). In men, those in the “high” FOXP3/CD4 ratio group appeared more likely to have stage 3 or 4 disease at diagnosis compared to the “low” group (66.7% vs 36.8%, p=0.139). This was not seen in women (33.3% vs 38.9%, p=0.718). Conclusions: More T-regs infiltrated DLBCL in women than in men. This is difficult to explain, but could be a clue to the relationship between survival and gender in DLBCL. Paradoxically, high T-regs predicted worse overall survival in men, but better overall survival in women. Also, stage 3 or 4 disease at diagnosis was associated with high T-regs in men but not in women. To confirm the significance of these findings, a larger sample size and prospective study design will be needed. Figure 1 Survival in Men with DLBCL by FoxP3/CD4&#x2028; p=0.052 Figure 1. Survival in Men with DLBCL by FoxP3/CD4&#x2028; p=0.052 Figure 2 Survival in Women with DLBCL by FoxP3/CD4&#x2028; p=0.048 Figure 2. Survival in Women with DLBCL by FoxP3/CD4&#x2028; p=0.048


2017 ◽  
Vol 1 (8) ◽  
pp. 486-493 ◽  
Author(s):  
Shoko Nakayama ◽  
Taiji Yokote ◽  
Toshikazu Akioka ◽  
Nobuya Hiraoka ◽  
Uta Nishiwaki ◽  
...  

Key Points In the patients with DLBCL, NOS, a high infiltration of FOXP3-positive cells in tumor was associated with a better prognosis. However, a high infiltration of FOXP3/CTLA-4 double-positive cells, which are eTregs, was associated with a worse prognosis.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Selin Merdan ◽  
Kritika Subramanian ◽  
Turgay Ayer ◽  
Johan Van Weyenbergh ◽  
Andres Chang ◽  
...  

AbstractThe clinical risk stratification of diffuse large B-cell lymphoma (DLBCL) relies on the International Prognostic Index (IPI) for the identification of high-risk disease. Recent studies suggest that the immune microenvironment plays a role in treatment response prediction and survival in DLBCL. This study developed a risk prediction model and evaluated the model’s biological implications in association with the estimated profiles of immune infiltration. Gene-expression profiling of 718 patients with DLBCL was done, for which RNA sequencing data and clinical covariates were obtained from Reddy et al. (2017). Using unsupervised and supervised machine learning methods to identify survival-associated gene signatures, a multivariable model of survival was constructed. Tumor-infiltrating immune cell compositions were enumerated using CIBERSORT deconvolution analysis. A four gene-signature-based score was developed that separated patients into high- and low-risk groups. The combination of the gene-expression-based score with the IPI improved the discrimination on the validation and complete sets. The gene signatures were successfully validated with the deconvolution output. Correlating the deconvolution findings with the gene signatures and risk score, CD8+ T-cells and naïve CD4+ T-cells were associated with favorable prognosis. By analyzing the gene-expression data with a systematic approach, a risk prediction model that outperforms the existing risk assessment methods was developed and validated.


2021 ◽  
Vol 10 (8) ◽  
pp. 1768
Author(s):  
Zhitao Wang ◽  
Rui Jiang ◽  
Qian Li ◽  
Huiping Wang ◽  
Qianshan Tao ◽  
...  

Myeloid-derived suppressor cells (MDSCs) are defined as negative regulators that suppress the immune response through a variety of mechanisms, which usually cluster in cancer, inflammation, and autoimmune diseases. This study aims to investigate the correlation between M-MDSCs and the clinical features of diffuse large B-cell lymphoma (DLBCL) patients, as well as the possible accumulation mechanism of M-MDSCs. The level of M-MDSCs is significantly increased in newly diagnosed and relapsed DLBCL patients. Regarding newly diagnosed DLBCL patients, the frequency of M-MDSCs is positively correlated with tumor progression and negatively correlated with overall survival (OS). More importantly, the level of M-MDSCs can be defined as a biomarker for a poor prognosis in DLBCL patients. Additionally, interleukin-35 (IL-35) mediates the accumulation of M-MDSCs in DLBCL patients. Anti-IL-35 treatment significantly reduces levels of M-MDSCs in Ly8 tumor-bearing mice. Thus, M-MDSCs are involved in the pathological process of DLBCL. Targeting M-MDSCs may be a promising therapeutic strategy for the treatment of DLBCL patients.


2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Gary Kwok Cheong Lee ◽  
Dorothee Bienzle ◽  
Stefan Matthias Keller ◽  
Mei-Hua Hwang ◽  
Nikos Darzentas ◽  
...  

Abstract Background Lymphocytic neoplasms with frequent reactive lymphocytes are uncommonly reported in dogs, and can pose a diagnostic challenge. Different diagnostic modalities such as cytology, flow cytometry, histopathology, immunohistochemistry, and clonality testing, are sometimes required for a diagnosis. This report illustrates the value of using a multi-modal diagnostic approach to decipher a complex lymphocytic tumor, and introduces immune repertoire sequencing as a diagnostic adjunct. Case presentation A 10-month-old Great Dane was referred for marked ascites. Cytologic analysis of abdominal fluid and hepatic aspirates revealed a mixed lymphocyte population including numerous large lymphocytes, yielding a diagnosis of lymphoma. Flow cytometrically, abdominal fluid lymphocytes were highly positive for CD4, CD5, CD18, CD45, and MHC II, consistent with T cell lymphoma. Due to a rapidly deteriorating clinical condition, the dog was euthanized. Post mortem histologic evaluation showed effacement of the liver by aggregates of B cells surrounded by T cells, suggestive of hepatic T cell-rich large B cell lymphoma. Immune repertoire sequencing confirmed the presence of clonal B cells in the liver but not the abdominal fluid, whereas reactive T cells with shared, polyclonal immune repertoires were found in both locations. Conclusions T cell-rich large B cell lymphoma is a rare neoplasm in dogs that may be challenging to diagnose and classify due to mixed lymphocyte populations. In this case, the results of histopathology, immunohistochemistry and immune repertoire sequencing were most consistent with a hepatic B cell neoplasm and reactive T cells exfoliating into the abdominal fluid. Immune repertoire sequencing was helpful in delineating neoplastic from reactive lymphocytes and characterizing repertoire overlap in both compartments. The potential pitfalls of equating atypical cytomorphology and monotypic marker expression in neoplasia are highlighted.


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