Background:T-cell lymphomas (TCLs) are a group of heterogenous cancers with poor rates and duration of response. There remains a great challenge in risk stratification of these cancers. Cluster of differentiation (CD) 5 has shown prognostic implication in many subtypes of B-cell lymphoma; however, its role in TCLs is not known.Methods:We performed a single-institution retrospective analysis of newly diagnosed patients with TCL. CD5 positivity was determined based on positive results via immunohistochemistry and/or flow cytometry. We used univariate and multivariable analysis of biological factors to assess their association with survival outcomes.Results:A total of 194 patients with TCL spanning 14 subtypes were identified. CD5 positivity was noted in 63% of patients, with the highest proportion of CD5 expression in TFH TCL (93.9%), PTCL-NOS (82.9%), and ATLL (77.8%) (p= 0.00004). Older age at diagnosis (p= 0.001), stage III or IV disease (p= 0.05), and bone marrow involvement (p= 0.003) were also associated with CD5 expression. Complete response rates were numerically lower in patients with CD5+ TCL across all subtypes. OS/PFS was not statistically associated with CD5 status in the overall cohort; however there was significantly decreased OS in CD5+ TFH TCL (p= 0.04) and CD5+ ATLL (p= 0.04) patients.Conclusions:This study represents the first to examine CD5 expression as a prognostic biomarker for outcomes in TCL. The frequent expression of CD5 in the most common nodal TCL in the Western world underpins its potential as an attractive target for cellular therapies. Confirmation of these findings in a larger cohort and investigation of potential pathophysiological mechanisms explaining our observations are planned.
背景：T细胞淋巴瘤（TCL）是一组异质性癌症，其缓解率和缓解持续时间均较差。这些癌症的风险分层仍面临巨大挑战。分化簇（CD）5已在许多B细胞淋巴瘤亚型中显示出预后意义；然而，其在TCL中的作用尚不明确。 方法：我们对新诊断的TCL患者进行了单机构回顾性分析。CD5阳性通过免疫组织化学和/或流式细胞术的阳性结果确定。我们采用单变量和多变量分析评估生物学因素与生存结局的关联。 结果：共纳入194例涵盖14种亚型的TCL患者。63%的患者存在CD5阳性表达，其中TFH TCL（93.9%）、PTCL-NOS（82.9%）和ATLL（77.8%）的CD5表达比例最高（p=0.00004）。诊断时年龄较大（p=0.001）、III或IV期疾病（p=0.05）以及骨髓受累（p=0.003）也与CD5表达相关。在所有亚型中，CD5+ TCL患者的完全缓解率数值上较低。在整个队列中，总生存期/无进展生存期与CD5状态无统计学关联；但在CD5+ TFH TCL（p=0.04）和CD5+ ATLL（p=0.04）患者中，总生存期显著降低。 结论：本研究首次探讨了CD5表达作为TCL预后生物标志物的价值。CD5在西方世界最常见的淋巴结TCL中频繁表达，这为其作为细胞疗法有吸引力的潜在靶点提供了依据。我们计划在更大规模队列中验证这些发现，并研究解释我们观察结果的潜在病理生理机制。
Prevalence and Prognostication of CD5+ Mature T-Cell Lymphomas
肿瘤(癌症)患者之家