Proliferative Tumor-Infiltrating Lymphocytes' Abundance within the Microenvironment Impacts Clinical Outcome in Cutaneous B-Cell Lymphomas

[Research progress of tumor-infiltrating lymphocytes in malignant hematological diseases]

In recent years, immunotherapy has been progressing rapidly in tumor treatment, among which, adoptive immunotherapy of immunologically active cells has also gained increasing attention in the treatment of malignant hematological diseases. Tumor-infiltrating lymphocytes are a heterogeneous class of T-cell-based lymphocytes with high heterogeneity. As an important component of the tumor microenvironment, TILs are crucial in the development of malignant tumors. TILs are a new type of immunoreactive cells discovered after lymphokine-activated killer cells, which can show high specificity and efficacy without the need for large amounts of interleukin-2. Tumor immunotherapy with TILs has shown encouraging results and is valuable in determining patient prognosis. In this paper, we review the composition and characteristics of TILs and their progress in malignant hematologic diseases.

The significance of upfront autologous stem cell transplantation for high-intermediate/high-risk stage IV diffuse large B-cell lymphoma

BACKGROUND

Diffuse large B-cell lymphoma (DLBCL) is the most common (30%-35%) type of B-cell lymphoma. Only about 60% of all newly diagnosed advanced-stage DLBCL can be completely treated with x6 R-CHOP. High-dose chemotherapy (HDCT) followed by autologous hematopoietic stem cell transplantation in the first remission (upfront auto-HSCT) can serve as an option to improve a prognosis in these patients.

AIMS

This trial aimed to improve prognosis in DLBCL by upfront auto-HSCT.

METHODS AND RESULTS

A group of 105 patients: DLBCL NOS, age 18-65, stage IV, IPI ≥2, CR/PR after x6 R-CHOP/DA-EPOCH-R from 2010 to 2019 at NMRC of Oncology named after N.N.Petrov of MoH of Russia was retrospectively analyzed. The HSCT group included patients with upfront HDCT followed by auto-HSCT (n = 35). The control group included patients with non-invasive follow-up after induction (n = 70). Primary endpoint was progression-free survival (PFS). Secondary endpoints were overall survival (OS), response rate and relapse rate. The 3-year OS (p = .013) and 3-year PFS (p = .033) were significantly higher in the HSCT group. The 3-year OS was decreased by the occurrence of relapse (p ≤ .001) and weight loss (B-symptom) (p = .04). DEL was the negative prognostic factor for 3-year PFS in all patients (p = .001) and control group (p = .001). DA-EPOCH-R significantly increased the 3-year PFS (p = .041).

CONCLUSION

Upfront HDCT followed by auto-HSCT can increase 3-year OS and PFS and improve prognosis in DLBCL NOS, age 18-65, stage IV, IPI ≥2 patients.