MP92-03 B-LYMPHOCYTES (BL) DIFFERENTIATION IS ATYPICAL IN CLEAR CELL RENAL CELL CARCINOMA (CCRCC) AND LOW PREOPERATIVE BL COUNT IS ASSOCIATED WITH POOR CANCER SPECIFIC SURVIVAL (CSS)

Abstract

You have accessJournal of UrologyKidney Cancer: Basic Research & Pathophysiology III1 Apr 2016MP92-03 B-LYMPHOCYTES (BL) DIFFERENTIATION IS ATYPICAL IN CLEAR CELL RENAL CELL CARCINOMA (CCRCC) AND LOW PREOPERATIVE BL COUNT IS ASSOCIATED WITH POOR CANCER SPECIFIC SURVIVAL (CSS) Mohammed Haseebuddin, Alexander MacFarlane, Karen Ruth, Robert Uzzo, Elizabeth Plimack, Mowafaq Jillab, Essel Dulaimi, Tahseen Al-Saleem, and Kerry Campbell Mohammed HaseebuddinMohammed Haseebuddin More articles by this author , Alexander MacFarlaneAlexander MacFarlane More articles by this author , Karen RuthKaren Ruth More articles by this author , Robert UzzoRobert Uzzo More articles by this author , Elizabeth PlimackElizabeth Plimack More articles by this author , Mowafaq JillabMowafaq Jillab More articles by this author , Essel DulaimiEssel Dulaimi More articles by this author , Tahseen Al-SaleemTahseen Al-Saleem More articles by this author , and Kerry CampbellKerry Campbell More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2636AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES BL serve as important antigen-presenting cells, whereby B cell antigen receptor-mediated endocytosis allows concentration of small amounts of specific antigen to present them efficiently. We theorized that BL are atypically differentiated in ccRCC and that their decrease interferes with antigen presentation and is prognostic of poor outcomes. METHODS Blood samples were obtained from RCC patients (n = 90) before partial or radical nephrectomy and age-similar healthy controls (n = 25). Flow cytometric (FC) data were quantified as mean fluorescence intensity (MFI) or % cells that express a biomarker. Patients were excluded if they had comorbid CLL, prior surgeries for RCC, non-ccRCC histology, or if the FC data was missing. BL were defined as CD45+/CD19+ and further characterized with other markers. Low BL count was defined to be below the first quartile level (141 cells/µl) in the healthy donors. BL counts were correlated with patient clinical data using non-parametric tests. CSS curves were estimated with Kaplan-Meier methods; Cox proportional hazards models were used to estimate adjusted hazard ratios (HR). RESULTS The average age of the ccRCC cohort (n = 69) was 60 (range 25-88) years. ccRCC patients and healthy donors had similar distributions of BL count [median 170/µl (28-679) vs. 189/µl (83-408), p = 0.49]. With median follow-up of 41 months (1-55 mo), 10 patients died with ccRCC. Patients with BL < 141/µl had lower CSS compared to patients with BL > 141/µl (p = 0.0013); CSS at 24 months for BL < 141/µl was 77.2% (95% CI 56.0%-89.0%) vs 97.2%% (95% CI 81.9%-99.6%) for BL > 141/µl. Low BL count was associated with M+ stage as a continuous (p = 0.04) and a dichotomous (p = 0.026) variable. In stepwise multivariable analysis, BL < 141/µl was associated with inferior CSS (HR = 10.21 [95% CI: 1.3-81.5], p = 0.028) with adjustment for T-stage, and borderline significant with subsequent adjustment for non-localized disease (HR = 8.07 [95% CI 0.97-67.1], p = 0.054). Compared to healthy controls, BL in ccRCC had higher percentages of CD20+/CD27+, CD20-/CD27+, CD27+/CD5-, CD27+/CD5+, CD20-/CD10-, CD20-/CD10+, CD20-/CD5+ BL and lower percentages of CD20+/CD10-, CD20+/CD27-, and CD27-/CD5- BL (all p-values <0.017, range <0.0001 to 0.017). CONCLUSIONS In patients with ccRCC, low BL is prognostic of poor CSS. BL in ccRCC patients are atypically differentiated with an increase in CD27+ and a decrease in CD20+ phenotype, suggesting a shift to plasma cell or memory BL. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e1162 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Mohammed Haseebuddin More articles by this author Alexander MacFarlane More articles by this author Karen Ruth More articles by this author Robert Uzzo More articles by this author Elizabeth Plimack More articles by this author Mowafaq Jillab More articles by this author Essel Dulaimi More articles by this author Tahseen Al-Saleem More articles by this author Kerry Campbell More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...