Blood advances · 2023
High PDL1/PDL2 gene expression correlates with worse outcome in primary mediastinal large B-cell lymphoma.
Многоцентровое исследованиеСтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Camus Vincent, Viailly Pierre-Julien, Drieux Fanny, Veresezan Elena-Liana, Sesques Pierre, Haioun Corinne, Durot Eric, Patey Martine, Rossi Cédric, Martin Laurent, Rainville Vinciane, Bohers Elodie, Ruminy Philippe, Penther Dominique, Kaltenbach Sophie, Bruneau Julie, Paillassa Jérome, Tournilhac Olivier, Willaume Alexandre, Antier Chloé, Lazarovici Julien, Lévêque Emilie, Decazes Pierre, Becker Stéphanie, Tonnelet David, Berriolo-Riedinger Alina, Gaulard Philippe, Tilly Hervé, Molina Thierry Jo, Traverse-Glehen Alexandra, Jardin Fabrice
Аннотация
Primary mediastinal B-cell lymphoma (PMBL) is an uncommon entity of aggressive B-cell lymphoma with an unusually good prognosis, except for 10-15% of chemotherapy-refractory cases. To identify earlier these higher risk patients, we performed molecular characterization of a retrospective multicenter cohort of patients treated with firstline immunochemotherapy. The traits of the patients with gene-expression profiling data (n = 120) were as follows: median age of 34 years (range, 18-67 years); female sex, 58.3%; elevated lactate dehydrogenase, 82.5%; Eastern Cooperative Oncology Group performance status score of 0 to 1, 85.7%; Ann Arbor stage I/II, 55%; International Prognostic Index score of 1 to 2, 64.4%; and median metabolic tumor volume, 290.4 cm3 (range, 15.7-1147.5 cm3). Among all 137 markers tested for correlation with survival data, only programmed death-ligand (PDL) 1 and PDL2 expression showed a prognostic impact. Overall, both PDL1 and PDL2 genes were highly expressed in 37 patients (30.8%; PDL1high/PDL2high). The baseline clinical characteristics of patients with PDL1high/PDL2high were similar to those of other patients. In univariate analysis, PDL1high/PDL2high status was associated with poor progression-free survival (PFS) (hazard ratio [HR], 4.292) and overall survival (OS; HR, 8.24). In multivariate analysis, PDL1high/PDL2high status was an independent prognostic factor of adverse outcomes (PFS: HR, 5.22; OS: HR, 10.368). We validated these results in an independent cohort of 40 patients and confirmed the significant association between PDL1high/PDL2high status and inferior PFS (HR, 6.11). High PDL1/PDL2 gene expression defines a population with strong immune privilege and poorer outcomes from standard chemotherapy who might benefit from firstline checkpoint inhibitor therapy.