Characterisation of EBV-specific CD8+ T cells in patients with Diffuse Large B-cell Lymphoma — ASN Events

Characterisation of EBV-specific CD8+ T cells in patients with Diffuse Large B-cell Lymphoma (#292)

Soi Cheng Law 1 , Colm Keane 1 , Kim-Anh Le Cao 2 , Maher K Gandhi 1 , Raymond J Steptoe 1
  1. The University of Queensland Diamantina Institute, Woolloongabba, QLD, Australia
  2. School of Mathematics and Statistics, Centre for Systems Genomics, The University of Melbourne, Melbourne, Victoria, Australia

Lymphoma is the most common haematological malignancy in Australia of which Diffuse Large B-cell Lymphoma (DLBCL) is the most common and most aggressive form. EBV infection is a known risk factor for lymphoma development. Patients with EBV+ DLBCL have poorer outcome compared than those with EBV-ve DLBCL.  Only 30-40% of DLBCL patients respond to checkpoint inhibitors. As EBV+ DLBCL has an immune-dominant type III viral latency (with absent lytic viral expression) and antigen presentation is intact potentially rendering EBV+ tumours immunogenic, it is unknown why B-cell lymphoma (BCL) is not cleared by the immune system, but T-cell dysfunction may be responsible. Some studies suggest a generalized immune suppression may be present whereas others indicate a reduced frequency of EBV latent antigen-specific CD8+ T cells but with increased exhaustion markers expression (e.g. LAG3, PD-1 and TIM-3) suggesting antigen-specific dysfunction. Therefore it remains unclear whether BCL inactivates CD8+ T cells in an antigen-specific manner. This study aims to clarify this by comparing EBV+ and EBV-ve DLBCL and determining the frequency and phenotype of EBV lytic- and latent-specific CD8+ T cells in patients by flow cytometry. Dextramers and a panel of markers such as LAG-3, TIM-3, PD-1 and TIGIT will be used to study EBV-specific CD8+ T cells. Healthy subjects and EBV-ve DLBCL patients will be studied to establish baseline and effect of antigen-specificity on CD8+ T cells, respectively. We predict that if BCL specifically inactivates tumour-antigen specific (i.e. EBV) CD8+ T cells then latent-antigen specific but not lytic-antigen specific CD8+ T cells, will exhibit an exhausted phenotype in the setting of EBV+ tumours. The outcomes may enable identification of the mechanisms underlying the poorer prognosis for EBV+ DLBCL and provide insights into the most effective therapies for these patients.

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