Abstract

Fc-epsilon receptor (CD23)-expressing follicular dendritic cells is a main prognostic factor in follicular lymphoma. Falaleeva N. A., Osmanov E. A., Tupitsyn N. N. Federal State Budgetary Institute N. N. Blokhin Russian Cancer Research Center, Health Ministry of Russian Federation, Moscow, Russia SUMMARY Follicular dendritic cells, expressing FcεRII or CD23 (FcεRIIFDCs) as a component of non-tumor environment have been studied in 232 follicular lymphoma (FL) patients. FcεRIIFDCs were found in 87.5% of follicular lymphoma cases and were associated with a nodular pattern of tumor growth (p = 0.000), but not the cytological grade of lymphoma. There were no associations of FcεRIIFDC with clinical prognostic factors (FLIPI indices) or with bone marrow involvement in FL patients by histology. The presence of FcεRIIFDCs in tumor tissue was an independent prognostic factor according to treatment results, i.e. frequency of CR, duration of OS and PFS. Bone marrow involvement significantly worsened the prognosis in FcεRIIFDC-positive group of patients. We suggest a new prognostic index (FDC-IP) that allows biochemical identification of the following patient groups: FcεRIIFDC-positive patients without bone marrow involvement (good prognosis), FcεRIIF-DC-positive patients with bone marrow involvement (intermediate prognosis), FcεRIIFDC-negative patients (poor prognosis). These 3 groups significantly differ (p = 0.000) both in OS and in PFS. This is the first evidence of the possibility to assess tumor behavior and treatment results in FL according to lymphoma biochemical and other than clinical parameters.

Highlights

  • Follicular lymphoma (FL) is a most frequent hemopoietic tumor in adults

  • This paper evaluates the role of non-tumor microenvironment in follicular lymphoma (FL) that is follicular dendritic cells (FDCs) expressing Fc-epsilon receptor II referred to as CD23 according to the differentiation antigen nomenclature

  • Immunohistochemical identification of CD23+ FDCs in FL tissue was made in 232 patients with 87.5% of positive tests (Table 1)

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Summary

Introduction

Follicular lymphoma (FL) is a most frequent hemopoietic tumor in adults. It is characterized by an indolent course and a rather favorable outcome. FL prognostic patterns are based on international prognostic indices (IPI) including FL specific FLIPI-1 and -2. These indices take into account degree of lymph node and bone marrow involvement, the presence and number of extranodal sites, anemia, increased serum lactate dehydrogenase levels and advanced age in some of them. Basing on the indices the patients are divided into risk groups and receive treatment [1]. Over the last 15 years, the treatment has included monoclonal antibody to CD20 as a mandatory component

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