Characterization and clinical impact of the tumor microenvironment in post-transplant aggressive B-cell lymphomas

Haematologica. 2023 Nov 1;108(11):3044-3057. doi: 10.3324/haematol.2023.282831.

Abstract

Post-transplant lymphoproliferative disorders (PTLD) are iatrogenic immune deficiency-associated lymphoid/plasmacytic proliferations developing due to immunosuppression in solid organ or hematopoietic stem cell allograft patients. PTLD are characterized by abnormal proliferation of lymphoid cells and have a heterogeneous clinical behavior. We profiled expression of >700 tumor microenvironment (TME)-related genes in 75 post-transplant aggressive B-cell lymphomas (PTABCL). Epstein-Barr virus (EBV)-positive PT-ABCL clustered together and were enriched for type I interferon pathway and antiviral-response genes. Additionally, a cytotoxicity gene signature associated with EBV-positivity and favorable overall survival (OS) (hazard ratio =0.61; P=0.019). In silico immunophenotyping revealed two subgroups with distinct immune cell compositions. The inflamed subgroup with higher proportions of immune cells had better outcome compared to noninflamed subgroup (median OS >200.0 vs. 15.2 months; P=0.006). In multivariable analysis with EBV status, International Prognostic Index, and rituximab-containing treatment, inflamed TME remained as an independent predictor for favorable outcome. We also compared TME between post-transplant and immunocompetent host diffuse large B-cell lymphomas (n=75) and discovered that the proportions of T cells were lower in PT-diffuse large B-cell lymphomas. In conclusion, we provide a comprehensive phenotypic characterization of PT-ABCL, highlighting the importance of immune cell composition of TME in determining the clinical behavior and prognosis of PT-ABCL.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Epstein-Barr Virus Infections* / complications
  • Herpesvirus 4, Human
  • Humans
  • Lymphoma, Large B-Cell, Diffuse* / complications
  • Lymphoma, Large B-Cell, Diffuse* / genetics
  • Lymphoproliferative Disorders* / pathology
  • Rituximab / therapeutic use
  • Tumor Microenvironment

Substances

  • Rituximab

Grants and funding

Funding: This research was funded by the grants from the Academy of Finland (to SL), Finnish Cancer Organizations (to SL), Sigrid Juselius Foundation (to SL), University of Helsinki (to SL), Helsinki University Hospital (to SL) and Scandiatransplant (to TF).