Scripties UMCG - Rijksuniversiteit Groningen
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Plasma PD-L1 is a suitable Diagnostic and Treatment Response Marker in Classical Hodgkin’s Lymphoma

(2019) Alsada, Z. (Zainab)

Hodgkin lymphoma (HL) is a cancer of the lymphatic system that mostly affects B-cells.
Improvements in HL treatments have increased the cure rate to 80%. However, between 10-30%
of HL patients relapse after achieving a complete response and 5-10% are refractory to initial
therapy. It is a matter of research to identify those group of patients for better optimization of the
treatment plan, especially with the emergence of new promising treatment agents such as
Nivolumab. Nivolumab modulates the immune response by blocking the PD-1 pathway
checkpoint. In this study, the significance of PD-1 pathway regulatory molecules was examined;
PD-1, PD-L1, PD-L2, CD83, VEGF and IDO as diagnostic, treatment monitoring and relapse
predictor markers. ELISA was performed using the plasma of 72 newly diagnosed HL patients
before and after therapy and the results were then compared to the plasma of healthy controls.
Among the six studied markers, only PD-L1, CD83 and VEGF plasma levels were higher in HL
patients compared to the controls. PD-L1 and VEGF level decreased significantly after therapy.
PD-L1 levels were significantly higher in patients with advanced stage HL (IIb-IV) compared to
patients with early stage HL (I-IIa) and it had a moderate correlation with the metabolic volume of
the tumor. None of the six markers significantly correlated with bulky disease. This research shows
that PD-L1 yielded the most promising results regarding its potential use as a diagnostic, treatment
monitoring and relapse predictor marker in HL. Further studies are needed to examine the role of
plasma PD-L1 as response predictor to PD-1 pathway inhibitors.

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