Spatial signatures identify immune escape via PD-1 as a defining feature of T-cell/histiocyte-rich large B-cell lymphoma

Gabriel K. Griffin, Jason L. Weirather, Margaretha G. M. Roemer, Mikel Lipschitz, Alyssa Kelley, Pei-Hsuan Chen, Daniel Gusenleitner, Erin Jeter, Christine Pak, Evisa Gjini, Bjoern Chapuy, Michael H. Rosenthal, Jie Xu, Benjamin J. Chen, Aliyah R. Sohani, Scott B. Lovitch, Jeremy S. Abramson, Jeffrey J. Ishizuka, Austin I. Kim, Caron A. JacobsonAnn S. LaCasce, Christopher D. Fletcher, Donna Neuberg, Gordon J. Freeman, F. Stephen Hodi, Kyle Wright, Azra H. Ligon, Eric D. Jacobsen, Philippe Armand, Margaret A. Shipp, Scott J. Rodig

Research output: Contribution to journalArticleAcademicpeer-review

24 Citations (Scopus)

Abstract

T-cell/histiocyte-rich large B-cell lymphoma (TCRLBCL) is an aggressive variant of diffuse large B-cell lymphoma (DLBCL) characterized by rare malignant B cells within a robust but ineffective immune cell infiltrate. The mechanistic basis of immune escape in TCRLBCL is poorly defined and not targeted therapeutically. We performed a genetic and quantitative spatial analysis of the PD-1/PD-L1 pathway in a multi-institutional cohort of TCRLBCLs and found that malignant B cells harbored PD-L1/PD-L2 copy gain or amplification in 64% of cases, which was associated with increased PD-L1 expression (P = .0111). By directed and unsupervised spatial analyses of multiparametric cell phenotypic data within the tumor microenvironment, we found that TCRLBCL is characterized by tumor-immune “neighborhoods” in which malignant B cells are surrounded by exceptionally high numbers of PD-L1–expressing TAMs and PD-1+ T cells. Furthermore, unbiased clustering of spatially resolved immune signatures distinguished TCRLBCL from related subtypes of B-cell lymphoma, including classic Hodgkin lymphoma (cHL) and DLBCL-NOS. Finally, we observed clinical responses to PD-1 blockade in 3 of 5 patients with relapsed/refractory TCRLBCL who were enrolled in clinical trials for refractory hematologic malignancies (NCT03316573; NCT01953692), including 2 complete responses and 1 partial response. Taken together, these data implicate PD-1 signaling as an immune escape pathway in TCRLBCL and also support the potential utility of spatially resolved immune signatures to aid the diagnostic classification and immunotherapeutic prioritization of diverse tumor types. Key Points: • Spatially resolved signatures of PD-1/PD-L1 signaling in the tumor microenvironment define T-cell/histiocyte-rich large B-cell lymphoma. • Three of 5 patients with relapsed/refractory TCRLBCL showed objective clinical responses to single-agent PD-1 blockade (pembrolizumab).
Original languageEnglish
Pages (from-to)1353-1364
Number of pages12
JournalBlood
Volume137
Issue number10
DOIs
Publication statusPublished - 11 Mar 2021

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