Prognostic relevance of bone marrow immune cell fractions in newly diagnosed B-cell non-Hodgkin lymphoma patients

Non-Hodgkin lymphomas (NHLs) are the most common hematological malignancies worldwide. Among these, B-cell lymphomas (B-NHLs) are the second leading cause of death in hematologic neoplasms. In this study, a detailed immunophenotypic analysis of lymphocytes in the bone marrow aspirate (BMA) of 75 patients with four different subtypes of B-NHLs was performed at diagnosis. The samples were analyzed by flow cytometry (FC) using a stain-lyse-no wash technique and a comprehensive six-color antibody panel. Our data showed a different trend in the percentage values of the distinct lymphocyte subsets, which did not seem to correlate with a worse prognosis, except for B cells in diffuse large B-cell lymphoma (DLBCL), which were significantly higher in stage IV than in stages II and III. ROC curve analysis showed that the B-cell percentage value could be used to predict the stage of the disease. Total lymphocytes and B cells were greater in lymphomas that presented a lower percentage of disease progression, specifically mantle cell lymphoma (MCL) and marginal zone lymphoma (MZL). In contrast, natural killer (NK) and T cells showed higher values in DLBCL and follicular lymphoma (FL), which progressed more frequently. Interestingly, in DLBCL patients with higher percentage values of double positive (DPT) and helper T cells (Th), we observed a good prognosis. Specifically, univariate Cox regression analyses indicated that a higher value of Th cells at diagnosis was a better prognostic predictor in patients with DLBCL. These preliminary findings encourage us to further investigate the role of lymphocyte subpopulations in B-cell NHL. This study provides a quick and inexpensive method for staging DLBCL by evaluating the percentage of CD19+ B lymphocytes using cytofluorimetry.In addition, the study showed that the evaluation of DPT and Th subsets can provide prognostic/predictive data, supporting their role in the immune response to cancer. This study provides a quick and inexpensive method for staging DLBCL by evaluating the percentage of CD19+ B lymphocytes using cytofluorimetry. In addition, the study showed that the evaluation of DPT and Th subsets can provide prognostic/predictive data, supporting their role in the immune response to cancer.