Prognostic impact of peripheral natural killer cells in primary central nervous system lymphoma

Prognostic Value of Circulating Lymphocyte Subsets in Cervical Cancer Following Postoperative Radiotherapy

Background and objective: The prognostic value of circulating lymphocyte subsets in cervical cancer patients receiving postoperative radiotherapy remains unclear. This study aimed to explore the prognostic significance of these lymphocyte subsets in this patient population. Methods: Peripheral blood samples were collected from 101 cervical cancer patients prior to receiving postoperative radiotherapy. Flow cytometry was utilized to determine the proportions and absolute counts of lymphocyte subsets, including total T cells, CD4+ T cells, CD8+ T cells, natural killer (NK) cells, and B cells. The Kaplan-Meier method and Cox regression analysis were employed to estimate the overall survival (OS) and identify the key prognostic factors. Receiver operating characteristic (ROC) curves were generated to assess the predictive accuracy. Results: The survival analysis indicated that patients with a decreased proportion of NK cells (P = 0.02) or reduced NK cell counts (P = 0.01) exhibited significantly poorer overall survival (OS) compared to those with higher levels of NK cells. In univariate Cox analysis, both the proportion of NK cells (P = 0.025; HR, 0.33; 95% CI, 0.12-0.87) and NK cell counts (P = 0.015; HR = 0.28) significantly influenced OS. In multivariate analysis, the proportion of CD4+ T cells (P = 0.02; HR, 0.08; 95% CI, 0.01-0.72) and NK cell counts (P = 0.08; HR, 0.11; 95% CI, 0.01-1.37) emerged as independent prognostic factors. The areas under the ROC curves (AUCs) for NK cell counts in predicting 1-, 2-, and 3-year survival were 0.66, 0.76, and 0.68, respectively. Patients diagnosed with stage IIIC1 exhibited a significant reduction in both the absolute counts and the proportion of NK cells compared to those diagnosed with earlier stages, specifically IB3 and IIA. Conclusions: Our study found that pre-treatment levels of circulating NK cell counts and proportions serve as promising prognostic biomarkers for cervical cancer patients undergoing postoperative radiotherapy.

Clinicopathological risk factors for prognosis and therapeutic response of primary central nervous system lymphoma in China: a single-center retrospective analysis of 118 cases

To investigate the prognostic significance of clinicopathological factors in patients with primary central nervous system lymphoma (PCNSL) in a single center. Patients newly diagnosed with PCNSL at our center were recruited between January 2019 and March 2023. Baseline demographic and clinicopathological data were collected retrospectively. The Kaplan-Meier method and Cox regression analysis were performed for survival analyses. A total of 118 patients were enrolled. The median age was 64 (IQR, 54-68). The median progression-free survival (PFS) and overall survival (OS) were 12.70 (95%CI, 9.73-23.30) months and 36.87 (95%CI, 25.57-NR) months, respectively. KPS < 70 and ECOG ≥ 3 were significantly associated with worse PFS and OS. High International Extranodal Lymphoma Study Group (IELSG) score (IELSG 4-5) and high-risk Memorial Sloan-Kettering Cancer Center (MSKCC) score were also adverse factors for PFS and OS. BTK inhibitors (BTKi) therapy (HR 0.39, 95% CI, 0.18-0.86, p = 0.020) and consolidation therapy (HR 0.19, 95% CI, 0.06-0.64, p = 0.007) were confirmed as independent favorable factors for OS. A high NK lymphocyte proportion was associated with worse OS (p = 0.008). Patients in the high NK lymphocyte group experienced a higher rate of primary tumor resistance (57.14%) than the low NK lymphocyte group (33.33%). KPS < 70, ECOG ≥ 3, IELSG 4-5, and high-risk MSKCC score are adverse factors for PFS and OS. Importantly, BTKi therapy and consolidation therapy are independent favorable factors for OS. Peripheral lymphocyte immunophenotyping could be a potential predictive indicator for prognosis and therapeutic response in PCNSL.

Soluble MIC-A, IPI, and response to treatment strongly predict survival in patients with germinal center diffuse large B cell lymphoma

Diffuse large B-cell lymphoma (DLBCL) is the most frequent lymphoma. MIC-A and MIC-B are the natural ligands for NKG2D, a receptor expressed in NK cells. MIC-A soluble isoforms (sMICA) have been described in different malignancies.

OBJECTIVES

To analyze lymphocyte subsets and sMIC-A in germinal center DLBCL.

MATERIALS AND METHODS

sMICA, sMICB, and peripheral blood lymphocyte subsets (CD4+, CD8+, NK, NKT, γδ T cells, and dendritic cells) were analyzed in 59 patients and 60 healthy donors.

RESULTS

Patients had decreased numbers of type 1 and type 2 dendritic cells, NK, iNKT, CD4 T, and CD8 T cells, and higher levels of sMIC-A. The 2-year PFS for high IPI scores and high sMIC-A was 24% and 28%, respectively. The 2-year OS for high IPI scores and high sMIC-A was 42% and 33%. The 2-year PFS and OS for patients not achieving response to treatment were 0% and 10%, respectively. The MICPI score (one point each for high IPI score and high sMIC-A) showed that those patients summing two points had worse PSF and OS.

CONCLUSIONS

Patients with DLBCL have decreased numbers of peripheral lymphocyte subsets and high levels of sMIC-A. The addition of sMIC-A to IPI could improve its prognostic relevance.

Harnessing natural killer cells for refractory/relapsed non-Hodgkin lymphoma: biological roles, clinical trials, and future prospective

Non-Hodgkin lymphomas (NHLs) are heterogeneous and are among the most common hematological malignancies worldwide. Despite the advances in the treatment of patients with NHLs, relapse or resistance to treatment is anticipated in several patients. Therefore, novel therapeutic approaches are needed. Recently, natural killer (NK) cell-based immunotherapy alone or in combination with monoclonal antibodies, chimeric antigen receptors, or bispecific killer engagers have been applied in many investigations for NHL treatment. The functional defects of NK cells and the ability of cancerous cells to escape NK cell-mediated cytotoxicity within the tumor microenvironment of NHLs, as well as the beneficial results from previous studies in the context of NK cell-based immunotherapy in NHLs, direct our attention to this therapeutic strategy. This review aims to summarize clinical studies focusing on the applications of NK cells in the immunotherapy of patients with NHL.

Machine learning-based pathomics signature of histology slides as a novel prognostic indicator in primary central nervous system lymphoma

PURPOSE

To develop and validate a pathomics signature for predicting the outcomes of Primary Central Nervous System Lymphoma (PCNSL).

METHODS

In this study, 132 whole-slide images (WSIs) of 114 patients with PCNSL were enrolled. Quantitative features of hematoxylin and eosin (H&E) stained slides were extracted using CellProfiler. A pathomics signature was established and validated. Cox regression analysis, receiver operating characteristic (ROC) curves, Calibration, decision curve analysis (DCA), and net reclassification improvement (NRI) were performed to assess the significance and performance.

RESULTS

In total, 802 features were extracted using a fully automated pipeline. Six machine-learning classifiers demonstrated high accuracy in distinguishing malignant neoplasms. The pathomics signature remained a significant factor of overall survival (OS) and progression-free survival (PFS) in the training cohort (OS: HR 7.423, p < 0.001; PFS: HR 2.143, p = 0.022) and independent validation cohort (OS: HR 4.204, p = 0.017; PFS: HR 3.243, p = 0.005). A significantly lower response rate to initial treatment was found in high Path-score group (19/35, 54.29%) as compared to patients in the low Path-score group (16/70, 22.86%; p < 0.001). The DCA and NRI analyses confirmed that the nomogram showed incremental performance compared with existing models. The ROC curve demonstrated a relatively sensitive and specific profile for the nomogram (1-, 2-, and 3-year AUC = 0.862, 0.932, and 0.927, respectively).

CONCLUSION

As a novel, non-invasive, and convenient approach, the newly developed pathomics signature is a powerful predictor of OS and PFS in PCNSL and might be a potential predictive indicator for therapeutic response.

Lymphocyte subsets and soluble forms of MIC-A and MIC-B are prognostic factors in non-Hodgkin lymphoma patients

MIC-A and MIC-B are the natural ligands for NKG2D, an activator receptor expressed in NK cells. Soluble isoforms of MIC-A and MIC-B (sMICA, sMICB) have been identified in different malignancies, affecting NK cells' cytotoxicity. The study was performed to determine the levels of sMICA, sMICB, the expression of MIC-A, and MIC-B on tumor tissues, and lymphocyte subpopulations (CD4 + , CD8 + , NK, NKT, Tγδ cells, B cells, monocytes) in 94 patients with non-Hodgkin's lymphoma (NHL) and 72 healthy donors.The most frequent lymphoma was diffuse large B cell lymphoma (48%). Patients with NHL had decreased numbers of CD4 T cells, CD8 T cells, B cells, monocytes, NK cells, type 1 dendritic cells, γδ T cells, and increased iNKT cells. Patients showed higher levels of sMIC-A and similar serum levels of sMIC-B.Survival was poorer in patients having higher LDH values and lower numbers of CD4 T cells, type 1 dendritic cells, gamma-delta T cells, and high levels of sMIC-A.In conclusion, high levels of sMIC and decreased numbers in circulating lymphocyte subsets are related to poor outcomes in NHL.