Premium
Expression of programmed cell death ligand‐1 by immune cells in the microenvironment is a favorable prognostic factor for primary diffuse large B‐cell lymphoma of the central nervous system
Author(s) -
Tsuyuki Yuta,
Ishikawa Eri,
Kohno Kei,
Shimada Kazuyuki,
Ohka Fumiharu,
Suzuki Yuka,
Mabuchi Seiyo,
Satou Akira,
Takahara Taishi,
Kato Seiichi,
Miyagi Shohei,
Ozawa Hiroyuki,
Kawano Tasuku,
Takagi Yusuke,
Hiraga Junji,
Wakabayashi Toshihiko,
Nakamura Shigeo
Publication year - 2021
Publication title -
neuropathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.701
H-Index - 61
eISSN - 1440-1789
pISSN - 0919-6544
DOI - 10.1111/neup.12705
Subject(s) - cd20 , immune system , diffuse large b cell lymphoma , tumor microenvironment , cd5 , lymphoma , medicine , cancer research , oncology , immunology
Primary diffuse large B‐cell lymphoma (DLBCL) of the central nervous system (PCNS‐DLBCL) is rare. Thirty‐nine patients consecutively diagnosed as having PCNS‐DLBCL were analyzed to highlight the prognostic value of the expression of programmed cell death ligand‐1 (PD‐L1) by neoplastic cells and immune cells in the microenvironment. They were positive for CD20 in all (100%), CD5 in two (5%), CD10 in nine (23%), BCL‐2 in 27 (69%), BCL‐6 in 34 (87%), and MUM‐1 in 37 (95%). Only one case was positive for neoplastic PD‐L1, with an unexpectedly long clinical course of 92 months. The remaining 38 cases were further divided into three groups based on the percentage of PD‐L1 + cells among microenvironmental immune cells. Cutoffs of < 5%, 5–40%, and ≥ 40% successfully stratified mean prognoses with three‐year overall survival (OS) of 21%, 63%, and 100% ( P = 0.009), respectively. Progression‐free survival (PFS) and OS were different between the groups with and without methotrexate (MTX)‐containing chemotherapy ( P = 0.007 and P < 0.001, respectively). Multivariate analysis identified three independent adverse factors of OS: PD‐L1 negativity (< 5%) on microenvironmental immune cells ( P = 0.027), deep structure involvement ( P = 0.034), and performance status (PS) 2–4 ( P = 0.009). The study showed that PD‐L1 expression on immune cells in the microenvironment was associated with prognosis among patients with PCNS‐DLBCL.