A Systemic Protein Deviation Score Linked to PD-1+ CD8+ T Cell Expansion That Predicts Overall Survival in Diffuse Large B Cell Lymphoma

Eivind Heggernes Ask, Astrid Tschan-Plessl, Thea Johanne Gjerdingen, Michelle Lu Sætersmoen, Hanna Julie Hoel, Merete Thune Wiiger, Johanna Olweus, Björn E. Wahlin, Ole Christian Lingjærde, Amir Horowitz, Amanda Cashen, Marcus Watkins, Todd A. Fehniger, Harald Holte, Arne Kolstad, Karl Johan Malmberg

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background: Current prognostic variables can only partly explain the large outcome heterogeneity in diffuse large B cell lymphoma (DLBCL). We aimed to investigate the utility of systems-level protein and immune repertoire profiling for outcome prognostication in DLBCL. Methods: In this retrospective study, we used proximity extension assay technology to quantify 81 immune-related proteins in serum or plasma in 2 independent cohorts in a total 111 DLBCL patients. Protein levels were assessed before and after treatment with rituximab and chemotherapy, and the patients were compared with 19 age- and sex-matched healthy blood donors. In a subset of the patients, we performed a broad mass cytometric characterization of immune cell repertoires in peripheral blood. Findings: Patients displayed large deviations in protein profiles compared with healthy controls. Development of a systemic protein deviation (SPD) score provided a 4-protein-based metric that reflected the overall degree of protein deviations compared with age- and sex-matched healthy blood donors. The SPD score identified patients with very poor overall survival in both cohorts and correlated with increased frequencies of peripheral blood PD-1+ CD8+ T cells, and expansion of myeloid-derived suppressor cells. Conclusions: Our results show that a simple metric based on measurement of a small set of serum or plasma proteins can be used to probe systemic immune changes associated with poor survival in DLBCL. This finding warrants further investigation in larger, prospective studies to establish a clinical prognostic biomarker.

Original languageEnglish
Pages (from-to)180-195.e5
Issue number2
StatePublished - Feb 12 2021


  • CD8 T cells
  • CyTOF
  • PD-1
  • Translation to Patients
  • biomarker
  • myeloid derived suppressor cells
  • proteomics
  • systems immunology


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