The influence of programmed cell death ligand 2 (PD-L2) expression on survival outcome and tumor microenvironment in diffuse large B cell lymphoma

Abstract

The frequency and significance of programmed cell death ligand (PD-L) 2 expression in diffuse large B cell lymphoma (DLBCL) remain undefined. We described the expression pattern of PD-L/PD-1 in 88 DLBCL patients using immunohistochemistry. The association between PD-L expression and clinical characteristics/outcomes were analyzed. PD-L1 and PD-L2 were expressed in 14.8% and 68.2% of DLBCL patients with median positivity on tumor cells of 100% and 90%, respectively. PD-1 on tumor-infiltrating lymphocytes (TILs) was expressed in 12.5% of patients. Interestingly, 45.5% of patients had PD-L2 expressing TILs which were significantly associated with bulky disease (p = .046) and elevated lactate dehydrogenase (p = .048). PD-L1 and/or PD-L2 expression on lymphoma cells was associated with inferior progression-free survival (Hazard ratio [HR] 2.20; 95% Confidence Interval [CI] 1.004–4.84, p = .049) and overall survival (HR 2.27; 95%CI 1.03–4.98, p = .042), using multivariate analysis. In summary, PD-L2 expression on DLBCL is common and, together with PD-L1, were related to poor outcomes.

Keywords:

• Programmed cell death ligand 1
• programmed cell death ligand 2
• programmed cell death 1
• diffuse large B-cell lymphoma
• immune checkpoint

Acknowledgements

We would like to express our profound gratitude to Mr. Preecha Reaungwechworrachai and administrative staff of the Department of Pathology who helped us retrieve the specimens, prepared, and stained the specimens.

Disclosure statement

All authors report no conflict of interest.

Additional information

Funding

This study was supported by research grants from the Ratchadapisek Sompotch Foundation, Cancer Run Research Foundation, and Research Collaborations in Hematologic Malignancies and Hematopoietic Stem Cell Transplantation.