Journal
BLOOD
Volume 132, Issue 8, Pages 825-836Publisher
AMER SOC HEMATOLOGY
DOI: 10.1182/blood-2018-04-843714
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Funding
- Bloodwise [14042]
- National Institutes of Health, National Cancer Institute grant [R01 CA161026]
- International Immune Oncology Network of Bristol-Myers Squibb
- Miller Family Fund
- National Institutes of Health, National Cancer Institute [U24CA224316]
- Helen Gurley Brown Fellowship
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In classical Hodgkin lymphoma (cHL), the host antitumor immune response is ineffective. Hodgkin Reed-Sternberg (HRS) cells have multifaceted mechanisms to evade the immune system, including 9p24.1/CD274(PD-L1)/PDCD1LG2(PD-L2) genetic alterations, overexpression of PD-1 ligands, and associated T-cell exhaustion and additional structural bases of aberrant antigen presentation. The clinical success of PD-1 blockade in cHL suggests that the tumor microenvironment (TME) contains reversibly exhausted T effector cells (Teffs). However, durable responses are observed in patients with b2-microglobulin/major histocompatibility complex (MHC) class I loss on HRS cells, raising the possibility of non-CD81 T cell-mediated mechanisms of efficacy of PD-1 blockade. These observations highlight the need for a detailed analysis of the cHL TME. Using a customized time-of-flight mass cytometry panel, we simultaneously assessed cell suspensions from diagnostic cHL biopsies and control reactive lymph node/tonsil (RLNT) samples. Precise phenotyping of immune cell subsets revealed salient differences between cHLs and RLNTs. The TME in cHL is CD41 T-cell rich, with frequent loss of MHC class I expression on HRS cells. In cHLs, we found concomitant expansion of T helper 1 (Th1)-polarized Teffs and regulatory T cells (Tregs). The cHL Th1 Tregs expressed little or no PD-1, whereas the Th1 Teffs were PD-11. The differential PD-1 expression and likely functional Th1-polarized CD41 Tregs and exhausted Teffs may represent complementary mechanisms of immunosuppression in cHL.
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