CD5+成熟T细胞淋巴瘤的患病率和预后

Prevalence and Prognostication of CD5+ Mature T-Cell Lymphomas

Cancers

影响因子:4.40000

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

摘要

背景：T细胞淋巴瘤（TCLS）是一组异质癌，速度较差和反应持续时间。这些癌症的风险分层仍然存在巨大的挑战。分化簇（CD）5在B细胞淋巴瘤的许多亚型中显示出预后的意义。但是，其在TCL中的作用尚不清楚。方法：我们对新诊断的TCL患者进行了单个机构回顾性分析。通过免疫组织化学和/或流式细胞仪确定CD5阳性的阳性。我们使用单变量和多变量分析生物学因素来评估其与生存结果的关联。结果：总共确定了194例TCL患者14个亚型。在63％的患者中发现了CD5阳性，在TFH TCL（93.9％），PTCL-NOS（82.9％）和ATLL（77.8％）中，CD5表达的比例最高（P = 0.00004）。诊断时的年龄（P = 0.001），III期或IV期疾病（P = 0.05）和骨髓受累（P = 0.003）也与CD5表达有关。所有亚型的CD5+ TCL患者在数值上均较低。 OS/PFS在整个队列中与CD5状态无统计学相关；但是，CD5+ TFH TCL（P = 0.04）和CD5+ ATLL（P = 0.04）患者的OS显着降低。结论：这项研究代表了第一个检查CD5表达作为TCL结果预后生物标志物的研究。西方世界中最常见的淋巴结TCL中CD5的频繁表达是其潜力作为细胞疗法的有吸引力的靶标。在较大的队列中确认了这些发现，并计划了解释我们观察结果的潜在病理生理机制。

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.