A recent study has found that low levels of FOXP3+ regulatory T cells are associated with worse progression-free survival (PFS) and more aggressive disease characteristics in patients with angioimmunoblastic T cell lymphoma (AITL). AITL, a rare form of T cell lymphoma known for its complex immune profile, often presents significant treatment challenges. Researchers aimed to clarify the role of FOXP3+ regulatory T cells (Tregs) in AITL, examining how their presence, or lack thereof, influences disease progression.
The study, which involved 46 patients with AITL, used advanced digital pathology techniques to measure FOXP3 expression within tumour tissues. Patients were categorised into high and low FOXP3 expression groups based on cell counts per high-power field (HPF) in tumour samples. The researchers discovered a distinct link between low FOXP3 expression and more severe clinical presentations. Patients in the low FOXP3 group were more likely to exhibit advanced disease stages, splenomegaly, B symptoms (such as fever, night sweats, and weight loss), and involvement of organs outside the lymph nodes.
Furthermore, patients with low FOXP3 expression demonstrated a significantly shorter PFS and a 2.3-fold higher risk of recurrence compared to those with higher FOXP3 levels. Interestingly, lower FOXP3 levels were also correlated with Epstein-Barr virus presence in tumour cells, a factor that might further complicate disease progression. A higher neutrophil-to-lymphocyte ratio was another marker of the aggressive disease in low FOXP3 patients.
These findings could be pivotal in refining risk assessment and guiding treatment approaches for AITL. By identifying patients with low FOXP3+ cell counts as having a higher risk of recurrence and more aggressive disease, clinicians may better tailor therapies, potentially improving patient outcomes in this challenging lymphoma subtype.
Reference
Liu H et al. Correlation of low numbers of intratumoral FOXP3+ cells with worse progression-free survival in angioimmunoblastic T cell lymphoma. J Clin Pathol. 2024;77:743-50.
