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

• Published in: Annals of medicine (Helsinki) Vol. 57; no. 1; p. 2490825
• Main Authors: Valvano, Luciana, Vilella, Rocchina, D’Auria, Fiorella, D’Arena, Giovanni, Libonati, Rossana, Soda, Michela, Telesca, Alessia, Pietrantuono, Giuseppe, Mansueto, Giovanna Rosaria, Villani, Oreste, D’Agostino, Simona, Calice, Giovanni, Statuto, Teodora
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 01.12.2025; Taylor & Francis Group
• Subjects: Adult; Aged; Aged, 80 and over; B cells; B-cell non-Hodgkin lymphoma; B-Lymphocytes - immunology; Bone Marrow - immunology; Bone Marrow - pathology; Bone Marrow Cells - immunology; Disease Progression; DLBCL; double positive T-cells; Female; Flow Cytometry; Humans; immune cells; Immunophenotyping; Lymphoma, B-Cell - diagnosis; Lymphoma, B-Cell - immunology; Lymphoma, B-Cell - pathology; Lymphoma, Large B-Cell, Diffuse - diagnosis; Lymphoma, Large B-Cell, Diffuse - immunology; Lymphoma, Large B-Cell, Diffuse - pathology; Lymphoma, Mantle-Cell - diagnosis; Lymphoma, Mantle-Cell - immunology; Lymphoma, Mantle-Cell - pathology; Male; Middle Aged; Oncology; Prognosis; Th cells; DLBCL; B-cell non-Hodgkin lymphoma; prognostic role; immune cells; prediction staging disease; double positive T-cells; flow cytometry; B cells; Th cells
• ISSN: 0785-3890; 1365-2060; 1365-2060
• DOI: 10.1080/07853890.2025.2490825

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.