Intratumoral Lymphocytes in Diffuse Large B-Cell Lymphoma (DLBCL) Prognosis Predictions

A study published in Leukemia & Lymphoma examined the prognostic potential of regulatory t-cells (Tregs) in patients with diffuse large B-cell lymphoma (DLBCL). The researchers, led by Chen Chang, MD, from the College of Medicine at the National Cheng Kung University Hospital in Tainan, Taiwan, found that higher intratumoral CD25 + FOXP3+ lymphocytes are favorable prognostic indicators for patients with DLBCL.

The study included a total of 70 patients. The investigators assessed intratumoral Tregs using double-stained CD25 and FOXP3 lymphocytes in formalin-fixed paraffin-embedded tissues, and then related them to clinical pathological outcomes. Other variables were also evaluated in the context of DLBCL prognoses.

The authors reported that increased numbers of intratumoral FOXP3 + lymphocytes (>2.4 cells per high-power field [HPF]; p = 0.004), as well as CD25 + FOXP3+ lymphocytes (>0.8/HPF; p <0.001), were both favorable prognostic indicators in patients with DLBCL. Other favorable indicators included age <70 years (p <0.001), stage I-II disease (p <0.002), normal serum lactic acid dehydrogenase (LDH) level (p <0.002), and low international prognostic index (IPI) risk score (p <0.001). After corrections, higher number of CD25 + FOXP3+ lymphocytes maintained its prognostic significance (p = 0.040).

The authors highlighted that “higher Treg infiltration was associated with increased infiltration by cytotoxic T-lymphocytes (γ = 0.294, p = 0.038) and nodal location (γ = 0.390, p = 0.004),” but not CD123+ plasmacytoid dendritic cells, “which were reported to induce Tregs with immune tolerance.”

Given their results, Dr. Chang and the study’s collaborators concluded that, consistent with other studies, Tregs appear to be a functional prognostic marker in patients with DLBCL.