High post-treatment serum levels of soluble programmed cell death ligand 1 predict early relapse and poor prognosis in extranodal NK/T cell lymphoma patients

Abstract

// Hua Wang 1, 2, 3, * , Liang Wang 1, 2, 3, * , Wen-Jian Liu 1, 2, 3, * , Zhong-Jun Xia 1, 2, 3 , Hui-Qiang Huang 4 , Wen-Qi Jiang 4 , Zhi-Ming Li 4 , Yue Lu 1, 2, 3 1 Department of Hematological Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China 2 State Key Laboratory of Oncology in South China, Guangzhou, 510060, China 3 Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China 4 Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China * These authors have contributed equally to this work Correspondence to: Yue Lu, email: dr_luyue@sina.com Keywords: extranodal NK/T cell lymphoma, prognosis, soluble programmed cell death ligand 1, asparaginase, minimal residual disease Received: January 09, 2016     Accepted: March 31, 2016     Published: April 20, 2016 ABSTRACT The impact of serum levels of soluble programmed cell death ligand 1 (sPD-L1) on prognosis in patients with Epstein-Barr virus-associated malignancies has never been investigated. We prospectively measured pre- and post-treatment serum sPD-L1 levels and evaluated their prognostic value in 97 patients with newly diagnosed, early stage extranodal NK/T-cell lymphoma (ENKTCL) treated with asparaginase-based chemotherapy followed by radiotherapy. For predicting survival outcomes, serum sPD-L1 levels of 3.23 ng/mL and 1.12 ng/mL were respectively identified for pre- and post-treatment cut-off levels. Patients with high pretreatment (>3.23 ng/mL) had shorter progression-free survival (PFS) and overall survival (OS). In a multivariate survival analysis, post-treatment sPD-L1 >1.12 ng/mL, treatment response (complete vs. non-complete response), and stage II disease were independent prognostic factors for shorter PFS and OS. In patients with a complete response, post-treatment sPD-L1 >1.12 ng/mL was associated with shorter PFS and OS. In patients with high pretreatment sPD-L1 levels (>3.23 ng/mL), low post-treatment sPD-L1 level (≤1.12 ng/mL) correlated with longer PFS and OS. Our data suggest the post-treatment sPD-L1 level is a potent biomarker for predicting early relapse and poor prognosis in early stage ENKTCL patients treated with asparaginase, and may be a useful marker of minimal residual disease.