PD1 is highly expressed in diffuse large B-cell lymphoma with hepatitis B virus infection

by Zhihe Liu, Siyun Li, Yingmin Liu, Wei Guo, Ou Bai

The purpose of this study was to determine the association between PD1 expression and the clinical prognosis of diffuse large B-cell lymphoma (DLBCL) co-occurring with hepatitis B virus (HBV) infection.

A total of 165 patients presented with newly diagnosed and untreated DLBCL at the First Hospital of Jilin University, Changchun, China, between 2011.01 and 2014.12. Complete clinical information was available for 152 of these 165 patients. We retrospectively reviewed the results of HBV serum marker assays and the clinical information of these 152 DLBCL patients from our hospital database; eventually, only 51 patients were enrolled in this study, and these 51 patients received the PD1 test item.

① The incidence of HBsAg prevalence was 13.2% (20/152) in this study; ② The incidence of PD1 expression in the HBsAg⁺ group was 4.3-fold higher than that in the HBsAg^—group (40.0% vs 9.4%; P = 0.010); ③ The clinical information, including sex, age, clinical stage, IPI, molecular subtype and chemotherapy status, was analyzed between the HBsAg⁺ and HBsAg^—groups, but there were no significant differences between the two groups; ④ The median OS and PFS of the patients in the HBsAg⁺ group were 36.5 months and 12 months, respectively; however, the median OS and PFS of patients in the HBsAg^—group were not reached (P = 0.033) and 32 months (P = 0.049), respectively; and ⑤ The median OS and PFS of PD1-positive patients in the HBsAg⁺ group were the worst (24 months and 9 months, respectively), whereas the median OS and PFS of PD1-negative patients in the HBsAg^—group were the best (not reached and 32 months, respectively).

Compared with patients in the HBsAg^—group, the incidence of PD1 expression was significantly higher in the HBsAg⁺ group, and the median OS and PFS times were the worst in PD1-positive patients in the HBsAg⁺ group. These results indicated that the dismal prognosis of patients with HBsAg⁺ may be related to the high rate of PD1 expression. Thus, a targeted PD1 treatment strategy may improve the prognosis of HBsAg⁺ DLBCL patients.