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PD-1/PD-L1 expression in extra-medullary lesions of multiple myeloma
Anna Crescenzi1, Ombretta Annibali2, Antonella Bianchi1
1Unit of Pathology, University Hospital Campus Bio-Medico, Rome, Italy.
Abstract:
Multiple myeloma patients may develop extraosseous involvement in the course of the disease making prognosis very poor and new drugs clearly needed. The PD-1/PD-L1 axis has emerged as a master immune checkpoint in antitumor responses and recent studies investigated the role of PD-L1 in multiple myeloma cells; no data however are still available about PD-L1 expression in extramedullary localizations. We demonstrate PD-L1 expression in 4/12 cases of extraosseous myeloma suggesting that these lesions represent a specialized microenvironment. We found presence of PD-1+ infiltrating lymphocytes in all observed cases supporting the relevance of PD-1/PD-L1 checkpoint in extramedullary myeloma. We also investigated the correlation in PD1/PD-L1 staining between marrow staining and EMP lesions.
Insights
Extraosseous involvement in multiple myeloma shows programmed death-ligand 1 (PD-L1) expression. This suggests PD-1/PD-L1 checkpoint relevance in extramedullary myeloma, highlighting potential therapeutic targets.
Area of Science:
- Oncology
- Immunology
- Hematology
Background:
- Extraosseous involvement in multiple myeloma (MM) portends a poor prognosis, necessitating novel therapeutic strategies.
- The programmed cell death protein 1 (PD-1)/programmed cell death protein 1 ligand (PD-L1) axis is a critical immune checkpoint influencing antitumor responses.
- While PD-L1 expression in MM cells is studied, its role in extramedullary lesions remains largely unknown.
Purpose of the Study:
- To investigate the expression of PD-L1 in extramedullary myeloma (EMP) lesions.
- To assess the presence of PD-1 expressing tumor-infiltrating lymphocytes in EMP.
- To explore the correlation of PD-1/PD-L1 expression between bone marrow and EMP.
Main Methods:
- Immunohistochemical analysis of PD-L1 expression in biopsy samples from EMP lesions.
- Evaluation of PD-1 positive infiltrating lymphocytes within the tumor microenvironment of EMP.
- Comparative analysis of PD-1/PD-L1 staining in paired bone marrow and EMP samples.
Main Results:
- PD-L1 expression was detected in 4 out of 12 (33.3%) evaluated cases of extraosseous myeloma.
- PD-1 positive infiltrating lymphocytes were identified in all analyzed EMP cases.
- Preliminary correlation analysis between marrow and EMP PD-1/PD-L1 staining was performed.
Conclusions:
- Extramedullary myeloma lesions exhibit PD-L1 expression, indicating a potentially specialized tumor microenvironment.
- The presence of PD-1+ lymphocytes underscores the significance of the PD-1/PD-L1 immune checkpoint pathway in extramedullary disease.
- These findings suggest that targeting the PD-1/PD-L1 axis may represent a viable therapeutic approach for patients with extramedullary multiple myeloma.
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