Checkpoint Inhibitors Hodgkin Lymphoma and Non-Hodgkin Lymphoma

The ligation of PD-1 with PD-L1 activates a critical immune checkpoint leading to T cell dysfunction, exhaustion, and tolerance. Anti-PD-1 or anti-PD-L1 monoclonal antibodies can reverse the immune checkpoint, releasing the brake on T cell responses. We provide a comprehensive review of the literature on the activity of checkpoint inhibitors in lymphoma.

We discuss the latest findings with checkpoint inhibitors in lymphoma and new promising studies incorporating these agents. Classical Hodgkin lymphoma is very sensitive to PD1/PL1 blockade due to genetic alterations in 9p21.1 leading to the high expression of PDL1. Although majority of NHLs have a much lower sensitivity to PD1/PDL1 blockade, a few subtypes such as primary CNS lymphoma, primary testicular lymphoma, primary mediastinal lymphoma harbor 9p21.1 alterations making them vulnerable to PD1 blockade. EBV-associated lymphomas have a virally mediated increased expression of PDL1 making them sensitive to PD1 blockade.