New Criteria for T-Cell Lymphoma Diagnosis

A group of Italian researchers have discovered new diagnostic criteria to differentiate peripheral T-cell lymphomas (PTCLs).

They present these findings in the August 2010 issue of the American Journal of Pathology.

PTCLs comprise a group of rare and aggressive non-Hodgkin lymphomas that develop from T-cells in different stages of maturity. These diseases have a poor prognosis, with a 5-year survival rate of around 25%.

Subtype differentiation of peripheral T-cell lymphomas, such as autoimmunoblastic T-cell lymphoma (AITL) and peripheral T-cell lymphomas of non-specific origin (PTCL/NOS), is critical for the application of specific therapeutic strategies.

Tripodo et al therefore examined the immunological microenvironment of PTCLs to find diagnostic criteria to differentiate AITLs and PTCL/NOS. They found that two types of immune cells, T helper 17 (Th17) cells and mast cells, directly contributed to the pro-inflammatory microenvironment of AITLs but not PTCL/NOS. From their data, they propose that AITL cells may directly recruit mast cells, which then secrete factors that result in the pro-inflammatory, Th17-generating microenvironment that leads to autoimmunity in these patients.

Tipodo and colleagues suggest "the immunological microenvironment of AITL, differently from that of PTCL/NOS, is characterized by the abundance of mast cells likely recruited by CXCL-13, produced, at least in part, by the neoplastic clone of Tfh derivation. In the AITL environment, infiltrating MCs might promote inflammation tipping the balance between immune regulation and autoimmunity and contributing to the local changes occurring in AITL-infiltrated tissues.

The possible clinical relevance of microenviromental patterns as well as the potential therapeutic impact of strategies interfering in such dynamics surely warrant further investigation."