Association of programmed cell death ligand 1 and circulating lymphocytes with risk of venous thromboembolism in patients with glioma
Introduction The role of the adaptive immune system in the pathophysiology of cancer-associated venous thromboembolism (VTE) has not been investigated in detail. Programmed cell death ligand 1 (PD-L1) is an immune checkpoint molecule responsible for immune evasion in several cancer entities, as expr...
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doaj-8b0e250f15fa446f9b8f9f2364d92f4a2021-04-02T18:57:19ZengElsevierESMO Open2059-70292020-05-015310.1136/esmoopen-2019-000647Association of programmed cell death ligand 1 and circulating lymphocytes with risk of venous thromboembolism in patients with gliomaMatthias Preusser0Christine Marosi1Anna S Berghoff2Florian Moik3Ingrid Pabinger4Cihan Ay5Pegah Mir Seyed Nazari6Florian Posch7Gerda Ricken8Julia Riedl9Lena Hell10Johannes A Hainfellner11Division of Oncology, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, AustriaDivision of Oncology, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, AustriaDivision of Oncology, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, AustriaDivision of Haematology and Haemostaseology, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, AustriaDivision of Haematology and Haemostaseology, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, AustriaDivision of Haematology and Haemostaseology, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, AustriaDivision of Haematology and Haemostaseology, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, AustriaDivision of Oncology, Medical University of Graz, Graz, AustriaInstitute of Neurology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, AustriaDivision of Haematology and Haemostaseology, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, AustriaDivision of Haematology and Haemostaseology, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, AustriaInstitute of Neurology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, AustriaIntroduction The role of the adaptive immune system in the pathophysiology of cancer-associated venous thromboembolism (VTE) has not been investigated in detail. Programmed cell death ligand 1 (PD-L1) is an immune checkpoint molecule responsible for immune evasion in several cancer entities, as expression on tumour cells silences the T cell-mediated immune response. Given the interrelation between inflammation, haemostasis and cancer, we aimed to investigate the association of players of the adaptive immunity (eg, lymphocytes, tumour PD-L1) with risk of VTE in patients with glioma, one of the most prothrombotic cancer types.Methods In this prospective observational single-centre cohort study, patients with newly diagnosed glioma or regrowth after resection were included. Primary endpoint was objectively confirmed VTE. At study inclusion, a blood draw was performed. Tumour PD-L1 expression was assessed via immunohistochemistry.Results In total, 193 patients were included. PD-L1 expression in ≥1% of tumour cells was observed in 20/193 (10.4%) glioma. In multivariable cox-regression analysis, on adjustment for age, sex and WHO grade IV, systemic lymphocyte counts were significantly associated with risk of VTE (HR per 1 G/L increase (95% CI): 1.15 (1.03 to 1.29), p=0.013). In contrast, no significant difference in risk of VTE was found regarding the PD-L1 status: the cumulative 24 months probability of VTE was 17.0% in patients with no PD-L1 and 11.8% in those with PD-L1 expressing tumours (p=0.663).Conclusion In summary, PD-L1 expression was not associated with risk of VTE. Interestingly, peripheral lymphocytes, which are key players in adaptive immunity, were linked to an increased risk of glioma-associated VTE.https://esmoopen.bmj.com/content/5/3/e000647.full |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Matthias Preusser Christine Marosi Anna S Berghoff Florian Moik Ingrid Pabinger Cihan Ay Pegah Mir Seyed Nazari Florian Posch Gerda Ricken Julia Riedl Lena Hell Johannes A Hainfellner |
spellingShingle |
Matthias Preusser Christine Marosi Anna S Berghoff Florian Moik Ingrid Pabinger Cihan Ay Pegah Mir Seyed Nazari Florian Posch Gerda Ricken Julia Riedl Lena Hell Johannes A Hainfellner Association of programmed cell death ligand 1 and circulating lymphocytes with risk of venous thromboembolism in patients with glioma ESMO Open |
author_facet |
Matthias Preusser Christine Marosi Anna S Berghoff Florian Moik Ingrid Pabinger Cihan Ay Pegah Mir Seyed Nazari Florian Posch Gerda Ricken Julia Riedl Lena Hell Johannes A Hainfellner |
author_sort |
Matthias Preusser |
title |
Association of programmed cell death ligand 1 and circulating lymphocytes with risk of venous thromboembolism in patients with glioma |
title_short |
Association of programmed cell death ligand 1 and circulating lymphocytes with risk of venous thromboembolism in patients with glioma |
title_full |
Association of programmed cell death ligand 1 and circulating lymphocytes with risk of venous thromboembolism in patients with glioma |
title_fullStr |
Association of programmed cell death ligand 1 and circulating lymphocytes with risk of venous thromboembolism in patients with glioma |
title_full_unstemmed |
Association of programmed cell death ligand 1 and circulating lymphocytes with risk of venous thromboembolism in patients with glioma |
title_sort |
association of programmed cell death ligand 1 and circulating lymphocytes with risk of venous thromboembolism in patients with glioma |
publisher |
Elsevier |
series |
ESMO Open |
issn |
2059-7029 |
publishDate |
2020-05-01 |
description |
Introduction The role of the adaptive immune system in the pathophysiology of cancer-associated venous thromboembolism (VTE) has not been investigated in detail. Programmed cell death ligand 1 (PD-L1) is an immune checkpoint molecule responsible for immune evasion in several cancer entities, as expression on tumour cells silences the T cell-mediated immune response. Given the interrelation between inflammation, haemostasis and cancer, we aimed to investigate the association of players of the adaptive immunity (eg, lymphocytes, tumour PD-L1) with risk of VTE in patients with glioma, one of the most prothrombotic cancer types.Methods In this prospective observational single-centre cohort study, patients with newly diagnosed glioma or regrowth after resection were included. Primary endpoint was objectively confirmed VTE. At study inclusion, a blood draw was performed. Tumour PD-L1 expression was assessed via immunohistochemistry.Results In total, 193 patients were included. PD-L1 expression in ≥1% of tumour cells was observed in 20/193 (10.4%) glioma. In multivariable cox-regression analysis, on adjustment for age, sex and WHO grade IV, systemic lymphocyte counts were significantly associated with risk of VTE (HR per 1 G/L increase (95% CI): 1.15 (1.03 to 1.29), p=0.013). In contrast, no significant difference in risk of VTE was found regarding the PD-L1 status: the cumulative 24 months probability of VTE was 17.0% in patients with no PD-L1 and 11.8% in those with PD-L1 expressing tumours (p=0.663).Conclusion In summary, PD-L1 expression was not associated with risk of VTE. Interestingly, peripheral lymphocytes, which are key players in adaptive immunity, were linked to an increased risk of glioma-associated VTE. |
url |
https://esmoopen.bmj.com/content/5/3/e000647.full |
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