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Xu P, Liu J, Chen H, Shang L, Wang F, Zhu Y, Guo Y, Li F, Yan F, Xie X, Li L, Gu W, Lin Y. Clinical significance of plasma PD-L1 + exosomes in the management of diffuse large B cell lymphoma. Ann Hematol 2023; 102:2435-2444. [PMID: 37162517 DOI: 10.1007/s00277-023-05259-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 05/01/2023] [Indexed: 05/11/2023]
Abstract
PD-L1+ exosome have been reported to be a promising prognostic biomarker in various cancers. However, its clinical value in diffuse large B cell lymphoma (DLBCL) has not been defined yet. In this study, a total of 165 plasma samples from 78 patients with DLBCL undergoing standard first-line R-CHOP regimens were collected at three different time points (pretreatment, and after 3 and 6 cycles of R-CHOP) to determine the proportions of PD-L1+ exosomes by flow cytometry. We found that high pretreatment plasma PD-L1+ exosome correlated with indicators of poor clinical outcome that included high Ki-67 expression (P = 0.02), double expressor lymphoma (P = 0.005), immunohistochemical PD-L1+ tumor tissue (P = 0.006), and the baseline maximal standardized uptake values (P = 0.0003). Pretreatment plasma PD-L1+ exosome was an independent factor by multivariate analysis with logistic regression (P = 0.0301). Moreover, the pretreatment PD-L1+ exosome was a strong predictor of final treatment responses of either CR or non-CR by ROC analysis (P < 0.001). PD-L1+ exosome level declined significantly in patients who experienced CR (pretreatment vs. after 3 cycles/after 6 cycles, P < 0.05), but not in the non-CR group. Intriguingly, plasma PD-L1+ exosome after 3 cycles (AUC = 0.857; 95%CI: 0.728-0.939) might represent a more sensitive indicator than radiographic assessment after 3 cycles (AUC = 0.626; 95%CI: 0.477-0.758) for evaluating the therapeutic response of DLBCL patients (P = 0.0136). Our results suggest that plasma PD-L1+ exosomes may represent a new biomarker for the dynamic monitoring of treatment response.
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Affiliation(s)
- Peng Xu
- Department of Hematology, First People's Hospital of Changzhou, Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
- Laboratory of Hematology, First People's Hospital of Changzhou, Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
| | - Juan Liu
- Department of Hematology, First People's Hospital of Changzhou, Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
- Laboratory of Hematology, First People's Hospital of Changzhou, Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
| | - Huijuan Chen
- Department of Hematology, First People's Hospital of Changzhou, Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
- Laboratory of Hematology, First People's Hospital of Changzhou, Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
| | - Limei Shang
- Department of Hematology, First People's Hospital of Changzhou, Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
- Laboratory of Hematology, First People's Hospital of Changzhou, Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
| | - Fei Wang
- Department of Hematology, First People's Hospital of Changzhou, Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
- Laboratory of Hematology, First People's Hospital of Changzhou, Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
| | - Yuandong Zhu
- Department of Hematology, First People's Hospital of Changzhou, Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
- Laboratory of Hematology, First People's Hospital of Changzhou, Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
| | - Yanting Guo
- Department of Hematology, First People's Hospital of Changzhou, Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
- Laboratory of Hematology, First People's Hospital of Changzhou, Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
| | - Feng Li
- Department of Hematology, First People's Hospital of Changzhou, Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
- Laboratory of Hematology, First People's Hospital of Changzhou, Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
| | - Feng Yan
- Department of Hematology, First People's Hospital of Changzhou, Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
- Laboratory of Hematology, First People's Hospital of Changzhou, Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
| | - Xiaobao Xie
- Department of Hematology, First People's Hospital of Changzhou, Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
- Laboratory of Hematology, First People's Hospital of Changzhou, Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
| | - Liang Li
- National Center for Liver Cancer, Shanghai, China.
| | - Weiying Gu
- Department of Hematology, First People's Hospital of Changzhou, Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China.
- Laboratory of Hematology, First People's Hospital of Changzhou, Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China.
| | - Yan Lin
- Department of Hematology, First People's Hospital of Changzhou, Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China.
- Laboratory of Hematology, First People's Hospital of Changzhou, Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China.
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