Editor's Note:The 66th American Society of Hematology (ASH) Annual Meeting concluded successfully from December 7 to 10, 2024, in San Diego, USA. As the largest and most comprehensive international academic conference in the field of hematology, ASH attracts numerous experts and scholars worldwide to discuss groundbreaking research and advancements in hematology.
At this year’s ASH meeting, the team led by Dr. Bing Xu and Dr. Zhijuan Lin from The First Affiliated Hospital of Xiamen University presented multiple studies, including one oral presentation. Their research covered various topics such as the immune microenvironment of Epstein-Barr Virus-positive diffuse large B-cell lymphoma (EBV+DLBCL), the prognostic relevance of SUVmax in follicular lymphoma (FL), and immune microenvironmental changes in FL patients with early progression. Hematology Frontier had the privilege of interviewing Professor Zhijuan Lin on-site to discuss her team's findings and the latest significant developments in FL research presented at the conference.01. Exploring the Immune Microenvironment in EBV+DLBCL
Hematology Frontier: One of your team’s studies (abstract 452) was selected for an oral presentation at this year’s ASH meeting. It investigated the immune microenvironment in EBV+ diffuse large B-cell lymphoma using imaging mass cytometry and spatial transcriptomics. Could you elaborate on this research and its clinical implications?
- Dr. Zhijuan Lin:Our oral presentation focused on the immune microenvironment of EBV+DLBCL, a condition associated with a generally poor prognosis. Using advanced imaging mass cytometry and spatial transcriptomics, we provided a comprehensive analysis of the immunosuppressive microenvironment characteristic of EBV+DLBCL and identified the intrinsic regulatory mechanisms responsible for its formation.
Study Overview:
The study utilized imaging mass cytometry and spatial transcriptomics to uncover the spatial structure of the immune microenvironment in EBV+DLBCL, with a specific focus on its regulation of anti-lymphoma immunity and response to immunochemotherapy.
02. Prognostic Relevance of SUVmax in Follicular Lymphoma (FL)
Hematology Frontier: Another of your team’s studies (abstract 4379) explored the correlation between SUVmax and the prognosis of follicular lymphoma. Could you explain the study design, findings, and its clinical significance?
- Dr. Zhijuan Lin:Previous studies have reported conflicting conclusions regarding the prognostic value of SUVmax in FL. Some found no correlation between SUVmax and FL transformation, while others suggested that higher SUVmax values were associated with poorer prognosis. To address these inconsistencies, we conducted a multicenter analysis involving FL patients across China with available SUVmax data.
Key Findings:
- Prognostic Relevance: We established that SUVmax is indeed correlated with the prognosis of FL patients in China. Higher SUVmax values were associated with worse outcomes.
- Underlying Mechanisms: Beyond tumor cell characteristics, elevated SUVmax values were linked to factors such as macrophage activity and angiogenesis within the immune microenvironment.
Further validation revealed that lenalidomide treatment could achieve prognostic outcomes comparable to combination chemotherapy in patients with high SUVmax values. Building on this, we plan to conduct related clinical trials. I believe these findings provide valuable insights for the treatment of high-risk FL patients in the long term.
03. CD163+ Macrophages and Tumor Immunity in Early-Progression FL
Hematology Frontier: Your team explored the role of CD163+ macrophages in regulating tumor immunity during the early progression of follicular lymphoma (abstract 1621). Could you elaborate on this study?
- Dr. Zhijuan Lin:In addition to transformed FL, patients with early-progressing FL also have a poor prognosis. Using advanced imaging mass cytometry techniques, we investigated the differences in immune environments between FL patients with and without early progression.
Our findings revealed that FL patients with CD163-positive macrophage infiltration exhibit an immunosuppressive microenvironment. This suggests that the immune microenvironment plays a crucial role in the early progression of FL.
Key Insight:
CD163+ macrophages coordinate tumor immunity during early progression by spatially enhancing FL’s resistance to CD8+ T-cell attack.
04. Key Advances in Follicular Lymphoma at ASH 2024
Hematology Frontier: Finally, could you summarize and comment on the most significant advancements in FL research presented at this year’s ASH meeting?
- Dr. Zhijuan Lin:The most noteworthy clinical research advancement in FL at this year’s ASH meeting was the development of bispecific antibodies (BsAbs) and T-cell therapies. These therapies have demonstrated promising efficacy across various treatment scenarios, including first-line, later-line, and transformed FL.
However, given the indolent nature of FL, a key challenge lies in optimizing the timing of BsAb therapy and designing effective treatment strategies to achieve better therapeutic outcomes. This includes balancing efficacy, safety, survival benefits, and cost-effectiveness for patients.
Looking ahead, immunotherapy is poised to deliver significant benefits in FL treatment, and its potential warrants further clinical exploration.
About Dr. Bing Xu
Dr. Bing Xu is a distinguished professor and doctoral supervisor at the First Affiliated Hospital of Xiamen University. He serves as the Director of Hematology at Xiamen University and the Director of the Hematology Institute.
- Expert Roles: Senior physician and recipient of special state subsidies Vice President of the Hematology Division of the Chinese Medical Doctor Association Chair of the Follicular Lymphoma Working Group in China
- Academic Achievements: Principal investigator of six major National Natural Science Foundation projects Published over 200 papers, including more than 100 SCI articles in Blood, JHO, and others, with a total impact factor exceeding 600 Recipient of eight provincial and ministerial awards for scientific and technological advancements
About Dr. Zhijuan Lin
Dr. Zhijuan Lin is a chief physician and associate professor at the First Affiliated Hospital of Xiamen University. She is a master’s supervisor and a graduate of the eight-year clinical medicine program at Peking University.
- Expert Roles: Young Committee Member of the Chinese Society of Hematology Vice Chair of the Youth Committee of the Fujian Lymphoma Association
- Academic Achievements: Recipient of grants from the National Natural Science Foundation and the Fujian Provincial Foundation Published over ten articles in Blood and other SCI journals as the first author
