@article{Suvi-Katri Leivonen_Marjukka Pollari_Oscar Brück_Teijo Pellinen_Matias Autio_Marja-Liisa Karjalainen-Lindsberg_Susanna Mannisto_Pirkko-Liisa Kellokumpu-Lehtinen_Olli Kallioniemi_Satu Mustjoki_Sirpa Leppä_2019, place={Pavia, Italy}, title={T-cell inflamed tumor microenvironment predicts favorable prognosis in primary testicular lymphoma}, volume={104}, url={https://haematologica.org/article/view/8777}, DOI={10.3324/haematol.2018.200105}, abstractNote={Primary testicular lymphoma is a rare lymphoid malignancy, most often, histologically, representing diffuse large B-cell lymphoma. The tumor microenvironment and limited immune surveillance have a major impact on diffuse large B-cell lymphoma pathogenesis and survival, but the impact on primary testicular lymphoma is unknown. Here, the purpose of the study was to characterize the tumor microenvironment in primary testicular lymphoma, and associate the findings with outcome. We profiled the expression of 730 immune response genes in 60 primary testicular lymphomas utilizing the Nanostring platform, and used multiplex immunohistochemistry to characterize the immune cell phenotypes in the tumor tissue. We identified a gene signature enriched for T-lymphocyte markers differentially expressed between the patients. Low expression of the signature predicted poor outcome independently of the International Prognostic Index (progression-free survival: HR=2.810, 95%CI: 1.228-6.431, <em>P</em>=0.014; overall survival: HR=3.267, 95%CI: 1.406-7.590, <em>P</em>=0.006). The T-lymphocyte signature was associated with outcome also in an independent diffuse large B-cell lymphoma cohort (n=96). Multiplex immunohistochemistry revealed that poor survival of primary testicular lymphoma patients correlated with low percentage of CD3<sup>+</sup>CD4<sup>+</sup> and CD3<sup>+</sup>CD8<sup>+</sup> tumor-infiltrating lymphocytes (<em>P</em>&lt;0.001). Importantly, patients with a high T-cell inflamed tumor microenvironment had a better response to rituximab-based immunochemotherapy, as compared to other patients. Furthermore, loss of membrane-associated human-leukocyte antigen complexes was frequent and correlated with low T-cell infiltration. Our results demonstrate that a T-cell inflamed tumor microenvironment associates with favorable survival in primary testicular lymphoma. This further highlights the importance of immune escape as a mechanism of treatment failure.}, number={2}, journal={Haematologica}, author={Suvi-Katri Leivonen and Marjukka Pollari and Oscar Brück and Teijo Pellinen and Matias Autio and Marja-Liisa Karjalainen-Lindsberg and Susanna Mannisto and Pirkko-Liisa Kellokumpu-Lehtinen and Olli Kallioniemi and Satu Mustjoki and Sirpa Leppä}, year={2019}, month={Jan.}, pages={338-346} }