CD8 expression in anaplastic large cell lymphoma correlates with noncommon morphologic variants and T-cell antigen expression suggesting biological differences with CD8-negative anaplastic large cell lymphoma

Hum Pathol. 2020 Apr:98:1-9. doi: 10.1016/j.humpath.2020.01.005. Epub 2020 Feb 4.

Abstract

Anaplastic large cell lymphoma (ALCL) is a T-cell neoplasm characterized by uniformly strong CD30 expression and common absence of T-cell markers. Most ALCL cases express CD4, but a small subset of ALCL cases has been reported to express CD8. Little is known about the clinicopathologic and prognostic features of CD8+ ALCL. In this study, CD8 was assessed in 158 patients with systemic ALCL: CD8 was positive in 13 of 67 (19%) ALK+ and 13 of 91 (14%) ALK-negative neoplasms. In ALK+ ALCL, the CD8+ subgroup more often showed a noncommon morphologic pattern (69% vs 13%, P = .0001) and was more often positive for CD2 (100% vs 45%, P = .001), CD3 (92% vs 24%, P = .0001), and CD7 (100% vs. 39%, P = .002), but less frequently positive for CD25 (50% vs. 100%, P = .02). Patients with ALK+ ALCL and CD8+ neoplasms also had a higher relapse rate (82% vs 48%, P = .05) and more often underwent stem cell transplant (73% vs 36%, P = .04). CD8 expression did not correlate with patient overall survival or progression-free survival regardless of ALK status (all P > 0.05). We conclude that CD8+ ALCL cases appear to be biologically different from the more common CD8-negative ALCL cases. Our data suggest that CD8 positivity in ALK+ ALCL helps to identify a subset of patients more prone to relapse or more in need of stem cell transplant during their clinical course, although there was no impact on survival in this cohort.

Keywords: Anaplastic large cell lymphoma; CD8; Pathology; Prognosis.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anaplastic Lymphoma Kinase / genetics
  • Antigens, CD7 / analysis*
  • Biomarkers, Tumor / analysis*
  • Biomarkers, Tumor / genetics
  • CD3 Complex / analysis*
  • CD8-Positive T-Lymphocytes / immunology*
  • CD8-Positive T-Lymphocytes / pathology
  • Child
  • Child, Preschool
  • Disease Progression
  • Female
  • Gene Rearrangement
  • Humans
  • Interleukin-2 Receptor alpha Subunit / analysis*
  • Lymphoma, Large-Cell, Anaplastic / genetics
  • Lymphoma, Large-Cell, Anaplastic / immunology*
  • Lymphoma, Large-Cell, Anaplastic / pathology
  • Lymphoma, Large-Cell, Anaplastic / therapy
  • Male
  • Middle Aged
  • Progression-Free Survival
  • Time Factors
  • Young Adult

Substances

  • Antigens, CD7
  • Biomarkers, Tumor
  • CD3 Complex
  • IL2RA protein, human
  • Interleukin-2 Receptor alpha Subunit
  • ALK protein, human
  • Anaplastic Lymphoma Kinase