Gene Expression Signatures for the Accurate Diagnosis of Peripheral T-Cell Lymphoma Entities in the Routine Clinical Practice

Amador, C; Bouska, A; Wright, G; Weisenburger, DD; Feldman, AL; Greiner, TC; Lone, W; Heavican, T; Smith, L; Pileri, S; Tabanelli, V; Ott, G; Rosenwald, A; Savage, KJ; Slack, G; Kim, WS; Hyeh, Y; Li, Y; Dong, G; Song, J; Ondrejka, S; Cook, JR; Barrionuevo, C; Lim, ST; Ong, CK; Chapman, J; Inghirami, G; Raess, PW; Bhagavathi, S; Gould, C; Blombery, P; Jaffe, E; Morris, SW; Rimsza, LM; Vose, JM; Staudt, L; Chan, WC; Iqbal, J

Author(s): Amador, C; Bouska, A; Wright, G; Weisenburger, DD; Feldman, AL; Greiner, TC; Lone, W; Heavican, T; Smith, L; Pileri, S; Tabanelli, V; Ott, G; Rosenwald, A; Savage, KJ; Slack, G; Kim, WS; Hyeh, Y; Li, Y; Dong, G; Song, J; Ondrejka, S; Cook, JR; Barrionuevo, C; Lim, ST; Ong, CK; Chapman, J; Inghirami, G; Raess, PW; Bhagavathi, S; Gould, C; Blombery, P; Jaffe, E; Morris, SW; Rimsza, LM; Vose, JM; Staudt, L; Chan, WC; Iqbal, J;
Details: Publication Year 2022-12-20,Volume 40,Issue #36,Page 4261-4275
Journal Title: Journal of Clinical Oncology
Publication Type: Research article
Abstract: PURPOSE: Peripheral T-cell lymphoma (PTCL) includes heterogeneous clinicopathologic entities with numerous diagnostic and treatment challenges. We previously defined robust transcriptomic signatures that distinguish common PTCL entities and identified two novel biologic and prognostic PTCL-not otherwise specified subtypes (PTCL-TBX21 and PTCL-GATA3). We aimed to consolidate a gene expression-based subclassification using formalin-fixed, paraffin-embedded (FFPE) tissues to improve the accuracy and precision in PTCL diagnosis. MATERIALS AND METHODS: We assembled a well-characterized PTCL training cohort (n = 105) with gene expression profiling data to derive a diagnostic signature using fresh-frozen tissue on the HG-U133plus2.0 platform (Affymetrix, Inc, Santa Clara, CA) subsequently validated using matched FFPE tissues in a digital gene expression profiling platform (nCounter, NanoString Technologies, Inc, Seattle, WA). Statistical filtering approaches were applied to refine the transcriptomic signatures and then validated in another PTCL cohort (n = 140) with rigorous pathology review and ancillary assays. RESULTS: In the training cohort, the refined transcriptomic classifier in FFPE tissues showed high sensitivity (> 80%), specificity (> 95%), and accuracy (> 94%) for PTCL subclassification compared with the fresh-frozen-derived diagnostic model and showed high reproducibility between three independent laboratories. In the validation cohort, the transcriptional classifier matched the pathology diagnosis rendered by three expert hematopathologists in 85% (n = 119) of the cases, showed borderline association with the molecular signatures in 6% (n = 8), and disagreed in 8% (n = 11). The classifier improved the pathology diagnosis in two cases, validated by clinical findings. Of the 11 cases with disagreements, four had a molecular classification that may provide an improvement over pathology diagnosis on the basis of overall transcriptomic and morphological features. The molecular subclassification provided a comprehensive molecular characterization of PTCL subtypes, including viral etiologic factors and translocation partners. CONCLUSION: We developed a novel transcriptomic approach for PTCL subclassification that facilitates translation into clinical practice with higher precision and uniformity than conventional pathology diagnosis.
Keywords: Humans; *Lymphoma, T-Cell, Peripheral/diagnosis/genetics; Transcriptome; Reproducibility of Results; Gene Expression Profiling; Prognosis
Department(s): Laboratory Research; Pathology
PubMed ID: 35839444
Publisher's Version: https://doi.org/10.1200/JCO.21.02707
Terms of Use/Rights Notice: Refer to copyright notice on published article.

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