title: PD-L1 expression on neoplastic or stromal cells is respectively a poor or good prognostic factor for adult T-cell leukemia/lymphoma.
abstract: Programmed cell death ligand 1 (PD-L1) is expressed on both tumor and tumor-infiltrating nonmalignant cells in lymphoid malignancies. The programmed cell death 1 (PD-1)/PD-L1 pathway suppresses host antitumor responses, although little is known about the significance of PD-1/PD-L1 expression in the tumor microenvironment. To investigate the clinicopathological impact of PD-L1 expression in adult T-cell leukemia/lymphoma (ATLL), we performed PD-L1 immunostaining in 135 ATLL biopsy samples. We observed 2 main groups: 1 had clear PD-L1 expression in lymphoma cells (nPD-L1(+), 7.4% of patients), and the other showed minimal expression in lymphoma cells (nPD-L1(-), 92.6%). Within the nPD-L1(-) group, 2 subsets emerged: the first displayed abundant PD-L1 expression in nonmalignant stromal cells of the tumor microenvironment (miPD-L1(+), 58.5%) and the second group did not express PD-L1 in any cell (PD-L1(-), 34.1%). nPD-L1(+) ATLL (median survival time [MST] 7.5 months, 95% CI [0.4-22.3]) had inferior overall survival (OS) compared with nPD-L1(-) ATLL (MST 14.5 months, 95% CI [10.1-20.0]) (P = .0085). Among nPD-L1(-) ATLL, miPD-L1(+) ATLL (MST 18.6 months, 95% CI [11.0-38.5]) showed superior OS compared with PD-L1(-) ATLL (MST 10.2 months, 95% CI [8.0-14.7]) (P = .0029). The expression of nPD-L1 and miPD-L1 maintained prognostic value for OS in multivariate analysis (P = .0322 and P = .0014, respectively). This is the first report describing the clinicopathological features and outcomes of PD-L1 expression in ATLL. More detailed studies will disclose clinical and biological significance of PD-L1 expression in ATLL.
authors.affiliation: Department of Pathology, Kurume University School of Medicine, Kurume, Japan;
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Miyoshi
authors.affiliation: Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan;
authors.forename: Junichi
authors.initials: J
authors.lastname: Kiyasu
authors.affiliation: Department of Pathology, Kurume University School of Medicine, Kurume, Japan; Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan;
authors.forename: Takeharu
authors.initials: T
authors.lastname: Kato
authors.affiliation: Department of Pathology, Kurume University School of Medicine, Kurume, Japan;
authors.forename: Noriaki
authors.initials: N
authors.lastname: Yoshida
authors.affiliation: Department of Pathology, Kurume University School of Medicine, Kurume, Japan;
authors.forename: Joji
authors.initials: J
authors.lastname: Shimono
authors.affiliation: Department of Surgery, Kurume University School of Medicine, Kurume, Japan;
authors.forename: Shintaro
authors.initials: S
authors.lastname: Yokoyama
authors.affiliation: Department of Hematology, Sasebo City General Hospital, Sasebo, Japan; and.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Taniguchi
authors.affiliation: Department of Pathology, Kurume University School of Medicine, Kurume, Japan;
authors.forename: Yuya
authors.initials: Y
authors.lastname: Sasaki
authors.affiliation: Department of Pathology, Kurume University School of Medicine, Kurume, Japan;
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kurita
authors.affiliation: Department of Pathology, Kurume University School of Medicine, Kurume, Japan;
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kawamoto
authors.affiliation: Department of Medicine and Biosystemic Science, Kyushu University Faculty of Medicine, Fukuoka, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Kato
authors.affiliation: Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan;
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Imaizumi
authors.affiliation: Department of Pathology, Kurume University School of Medicine, Kurume, Japan;
authors.forename: Masao
authors.initials: M
authors.lastname: Seto
authors.affiliation: Department of Pathology, Kurume University School of Medicine, Kurume, Japan;
authors.forename: Koichi
authors.initials: K
authors.lastname: Ohshima
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D060890:B7-H1 Antigen / Q000378:metabolism*; D014408:Biomarkers, Tumor / Q000378:metabolism*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D017154:Stromal Cells / Q000378:metabolism* / Q000473:pathology; D015996:Survival Rate; D059016:Tumor Microenvironment
chemical_list: D060890:B7-H1 Antigen; D014408:Biomarkers, Tumor; C423236:CD274 protein, human