Infiltration of CD163‐, PD‐L1‐ and FoxP3‐positive cells adversely affects outcome in patients with mantle cell lymphoma independent of established risk factors

Summary We characterised patients with mantle cell lymphoma (MCL) poor prognosis based on differences in immune infiltration. Different expressions of the tumour markers Cyclin D1 and sex‐determining region Y‐box transcription factor 11 (SOX11), cluster differentiation 3 (CD3), CD4, CD8, CD25, forkhead box protein P3 (FoxP3), T‐box TBX21 (T‐bet), programmed death 1 (PD‐1), programmed‐death ligand (PD‐L1) CD163 were investigated for all‐cause mortality 282 MCL time‐to‐progression (TTP) 106 clinical trial patients. With increasing age, a significantly lower infiltration CD3 + T lymphocytes was seen. T‐cell independent cellular antigen p53 (p53) expression, Ki‐67, morphology frequency cells. The higher PD‐L1‐expression above cut‐off [hazard ratio (HR) 1·97, 95% confidence interval (CI) 1·18–3·25, adjusted sex International Prognostic Index (MIPI)] cells (continuously, HR 1·51, CI 1·03–2·23, adjusting sex, morphology, Ki‐67 p53). In treated within Nordic Lymphoma Group MCL2/3 trials, TTP shorter FoxP3 (HR 3·22, 1·40–7·43) 6·09, 1·84–20·21), MIPI. When combined macrophages PD‐L1 or high regulatory indicated worse outcome established risk factors. infiltrate turn molecular characteristics malignant decreased age.