CD5+成熟T细胞淋巴瘤的患病率与预后：一项预后指标研究

Prevalence and Prognostication of CD5+ Mature T-Cell Lymphomas

Cancers

影响因子:4.4

分区:医学3区 / 肿瘤学3区

发表日期:2024 Oct 09

作者: Omar Elghawy, Miao Cao, Jason Xu, Daniel J Landsburg, Jakub Svoboda, Sunita D Nasta, Elise A Chong, Stephen J Schuster, Colin J Thomas, Jordan S Carter, Montreh Tavakkoli, Marco Ruella, Stefan K Barta

DOI: 10.3390/cancers16193430

摘要

背景：T细胞淋巴瘤（TCL）是一组异质性较强的癌症，具有较差的反应率和持续时间。针对这些癌症的风险分层仍是一个巨大挑战。分化簇（Cluster of differentiation, CD）5在多种B细胞淋巴瘤亚型中具有预后意义，但其在TCL中的作用尚不清楚。方法：我们在单一机构进行回顾性分析，研究新诊断TCL患者的临床资料。通过免疫组化和/或流式细胞术检测CD5阳性。利用单变量和多变量分析评估生物学因素与生存结果的相关性。结果：共识别出194例TCL患者，涵盖14个亚型。CD5阳性在患者中占63%，在TFH T细胞淋巴瘤（93.9%）、原发性外周T细胞淋巴瘤未分类型（PTCL-NOS）（82.9%）及成人T细胞白血病/淋巴瘤（ATLL）（77.8%）中表达比例最高（p = 0.00004）。年龄较大（p = 0.001）、III或IV期（p = 0.05）及骨髓浸润（p = 0.003）与CD5表达相关。所有亚型中，CD5阳性患者的完全缓解率略低。总体生存（OS）和无进展生存（PFS）与CD5状态无统计学关联，但在TFH CD5+和ATLL CD5+患者中，OS明显降低（p = 0.04）。结论：本研究首次探讨了CD5表达作为TCL预后生物标志物的作用。CD5在西方常见淋巴结TCL中的频繁表达，支持其作为细胞免疫治疗潜在靶点的可能性。未来需在更大样本中验证这些发现，并研究潜在的发病机制以解释观察结果。

Abstract

Background: T-cell lymphomas (TCLs) are a group of heterogenous cancers with poor rates and duration of response. There remains a great challenge in risk stratification of these cancers. Cluster of differentiation (CD) 5 has shown prognostic implication in many subtypes of B-cell lymphoma; however, its role in TCLs is not known. Methods: We performed a single-institution retrospective analysis of newly diagnosed patients with TCL. CD5 positivity was determined based on positive results via immunohistochemistry and/or flow cytometry. We used univariate and multivariable analysis of biological factors to assess their association with survival outcomes. Results: A total of 194 patients with TCL spanning 14 subtypes were identified. CD5 positivity was noted in 63% of patients, with the highest proportion of CD5 expression in TFH TCL (93.9%), PTCL-NOS (82.9%), and ATLL (77.8%) (p = 0.00004). Older age at diagnosis (p = 0.001), stage III or IV disease (p = 0.05), and bone marrow involvement (p = 0.003) were also associated with CD5 expression. Complete response rates were numerically lower in patients with CD5+ TCL across all subtypes. OS/PFS was not statistically associated with CD5 status in the overall cohort; however there was significantly decreased OS in CD5+ TFH TCL (p = 0.04) and CD5+ ATLL (p = 0.04) patients. Conclusions: This study represents the first to examine CD5 expression as a prognostic biomarker for outcomes in TCL. The frequent expression of CD5 in the most common nodal TCL in the Western world underpins its potential as an attractive target for cellular therapies. Confirmation of these findings in a larger cohort and investigation of potential pathophysiological mechanisms explaining our observations are planned.