Circulating myeloid-derived suppressor cells correlate with clinical outcome in Hodgkin Lymphoma patients treated up-front with a risk-adapted strategy.
In the attempt to find a peripheral blood biological marker that could mirror the dysregulated microenvironment of Hodgkin Lymphoma (HL), we analysed the amount of myeloid-derived suppressor cells (MDSC), including the three main sub-types (monocytic, granulocytic and CD34 + fraction). The absolute MDSC count was investigated in 60 consecutive newly diagnosed HL patients and correlated with clinical variables at diagnosis and outcome. Patients received standard-of-care chemotherapy with the exception of interim fluorodeoxyglucose positron emission tomography (PET-2)-positive patients, who were switched early to a salvage regimen. All MDSC subsets were increased in HL patients compared to normal subjects (P < 0·0001) and were higher in non-responders. However, a strong prognostic significance was limited to immature (CD34(+) ) MDSC. A cut-off level of 0·0045 × 10(9) /l for CD34(+) MDSC resulted in 89% (95% confidence interval [CI] 52-99%) sensitivity and 92% (95% CI 81-98%) specificity. The positive predictive value to predict progression-free survival was 0·90 for PET-2 and 0·98 for CD34(+) MDSC count; the negative predictive value was 0·57 for PET-2 and 0·73 for CD34(+) MDSC. PFS was significantly shorter in patients with more than 0·0045 × 10(9) CD34(+) MDSC cells/l at diagnosis and/or PET-2 positivity (P < 0·0001). In conclusion, all circulating MDSC subsets are increased in HL; CD34(+) MDSC predict short PFS, similarly to PET-2 but with the advantage of being available at diagnosis.
Department of Clinical and Molecular Biomedicine, Haematology Section, University of Catania, Catania, Italy; Fondazione Veronesi, Catania, Italy; Division of Haematology, AOU "Policlinico - Vittorio Emanuele", Catania, Italy.
Alessandra
A
Romano
Nunziatina Laura
NL
Parrinello
Calogero
C
Vetro
Stefano
S
Forte
Annalisa
A
Chiarenza
Amalia
A
Figuera
Giovanna
G
Motta
Giuseppe Alberto
GA
Palumbo
Massimo
M
Ippolito
Ugo
U
Consoli
Francesco
F
Di Raimondo
D000293:Adolescent; D000328:Adult; D000368:Aged; D018952:Antigens, CD34; D018572:Disease-Free Survival; D005260:Female; D006689:Hodgkin Disease / Q000097:blood* / Q000000981:diagnostic imaging / Q000401:mortality* / Q000628:therapy; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D022423:Myeloid Cells; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D011859:Radiography; D015996:Survival Rate
D018952:Antigens, CD34
hodgkin lymphoma; myeloid-derived suppressor cells; positron emission tomography-2