HUBUNGAN DENSITAS REGULATORY T-CELL DENGAN PROGNOSIS DIFFUSE LARGE B-CELL LYMPHOMA

RAMKITA, NORA and Murti, Krisna and Maulani, Heni and Andriyani Liberty, Iche (2024) HUBUNGAN DENSITAS REGULATORY T-CELL DENGAN PROGNOSIS DIFFUSE LARGE B-CELL LYMPHOMA. Masters thesis, Sriwijaya University.

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Abstract

Background: Diffuse large B-cell lymphoma (DLBCL) is the most common subtype, with 150,000 new cases yearly. Roughly 40% of patients who receive rituximab in addition to vincristine, cyclophosphamide, doxorubicin, and prednisone treatment have primary refractory disease or recurrence. Although the Ann Arbor stage could determine DLBCL prognosis, new biomarkers are needed to stratify patient prognosis adequately. Regulatory T-cell (Treg) subsets in the microtumor environment characterized by CD25+ FOXP3+ phenotype are known to play a role in immune modulation, further affecting DLBCL progression and prognosis. However, the Treg role is still controversial. This study aims to determine the Treg density and its correlation with the clinicopathologic features and DLBCL prognosis. Methods: An observational analytic study with a retrospective cohort study was conducted using 44 DLBCL samples period January 1st, 2019 to December 31st, 2022. All samples were immunostained with anti-CD25/anti-FOXP3 double-stained. Clinicohistopathology and overall survival data were obtained through medical records and telephone contact. Bivariate data and multivariate Cox's regression analysis were performed with the Hierarchically Well Formulated (HWF) principle, interaction assessment, and confounding assessment. Results: Bivariate analysis showed high Treg density was associated with early stage (I and II) DLBCL (p=0.001). The prognosis predictors that were independently associated with survival were LDH level [p<0.001; HR (CI 95%) 6.396 (2.757-14.841)], location [p=0.038; HR (CI 95%) 0.427 (0.191-0.954), B-symptoms [p<0.001; HR (CI 95%) 9.360 (2.763-31.705)], clinical stage [p<0.001; HR (CI 95%) 13.718 (3.983-47.238), and Treg density [p=0.043; HR (CI 95%) 2.379 (1.027-5.509). Multivariate analysis showed that the prognostic factors associated with survival were B-symptoms [p=0.021, HR (CI 95%) 12.619 (1.462-108.909)] and clinical stage [p=0.001, HR (CI 95%) 24.069 (4.004=144.656)]. Conclusion: Higher Treg infiltration is associated with early-stage DLBCL and better survival. Predictors of DLBCL survival were LDH level, tumor location, B-symptoms, and clinical stage. DLBCL patients with low Treg density tend to have low survival. The prognostic factors most associated with survival were B-symptoms and clinical stage.

Item Type:	Thesis (Masters)
Uncontrolled Keywords:	Diffuse large B-cell lymphoma; regulatory T-cell (Tregs); CD25; FOXP3; survival; prognosis.
Subjects:	R Medicine > RB Pathology > RB1-214 Pathology R Medicine > RB Pathology > RB24-33 Pathological anatomy and histology R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
Divisions:	04-Faculty of Medicine > 11718-Pathology Anatomy (Sp
Depositing User:	Nora Ramkita
Date Deposited:	23 Jul 2024 01:36
Last Modified:	23 Jul 2024 01:55
URI:	http://repository.unsri.ac.id/id/eprint/151807

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