Flow-cytometry-based evaluation of peripheral blood lymphocytes in prognostication of newly diagnosed DLBCL patients
Małgorzata Rusak1, Łukasz Bołkun2, Joanna Chociej-Stypułkowska1
1Department of Hematological Diagnostics, Medical University of Bialystok, Białystok, Poland.
Insights
Quantitative assessment of peripheral blood lymphocytes, including B cells, T cells, and regulatory T cells (Tregs), can improve prognostication for diffuse large B-cell lymphoma (DLBCL) patients. Lower lymphocyte counts and increased apoptosis correlate with advanced disease and poor outcomes.
Area of Science:
- Hematology
- Immunology
- Oncology
Background:
- Diffuse large B-cell lymphoma (DLBCL) is an aggressive non-Hodgkin lymphoma.
- Accurate prognostication is crucial for guiding treatment decisions in DLBCL patients.
Purpose of the Study:
- To evaluate the utility of quantitative assessment of peripheral blood lymphocytes in predicting DLBCL patient outcomes.
- To analyze specific lymphocyte subsets including B cells, T cells, and regulatory T cells (Tregs).
Main Methods:
- Flow cytometry was used to quantify absolute counts of lymphocytes, B cells, T cells, and Tregs.
- The percentage of apoptotic cells was also assessed in DLBCL patients.
- Patients were stratified into low (LR), medium (MR), and high (HR) risk groups.
Main Results:
- DLBCL patients with high-risk (HR) disease exhibited significantly lower absolute lymphocyte counts (ALC) and a higher percentage of apoptotic cells.
- HR and MR groups showed a significant decrease in the absolute number of T cells and Tregs compared to LR.
- Treatment with RCHOP did not normalize B cell, Treg counts, or apoptotic cell percentages in HR patients.
Conclusions:
- Lymphopenia, decreased T cells and Tregs, and reduced apoptotic cells correlate with advanced clinical staging in DLBCL.
- Elevated B cells and reduced Tregs post-treatment may predict poor outcomes in RCHOP-treated patients.
- Flow cytometry evaluation of peripheral blood lymphocytes offers a valuable tool for DLBCL prognostication.
Aims:
We aimed to analyse whether quantitative assessment of peripheral blood lymphocyte CD19(+)CD20(+)CD22(+)CD79a(+) B cells, CD3(+)CD4(+)CD5(+)CD8(+) T cells and CD4(+)CD25(+++)Foxp3high Treg can improve prognostication in DLBCL patients.
Methods:
The absolute count of lymphocytes, B-cells, T-cells and Treg-cells as well as the percentage of apoptotic cells were assessed by means of flow cytometry in all studied subjects.
Results:
Significantly lower level of ALC and the percentage of apoptotic cells have been observed exclusively in DLBCL patients with HR. We also showed, that in comparison with LR, in HR and MR groups, there is a significant decrease in the absolute number of T-cells and Tregs. The applied treatment does no normalize the number of B-cells, Tregs and apoptotic cells only in the case of HR patients.
Conclusions:
Lymphopenia, the decreased absolute number of T cells, Tregs, and a percentage of apoptotic cells, correlates with clinical staging in DLBCL patients. The increased number of B cells and the decreased level of Tregs and apoptotic cells after treatment might predict a poor clinical outcome in patients treated with RCHOP. Thereby, flow-cytometry-based evaluation of peripheral blood lymphocytes may be useful in prognostication of newly diagnosed DLBCL patients.
