FollicularhelperT-cellsimplicationsinneoplastic.docVIP

Follicular helper T-cells?: implications in neoplastic haematopathology Philippe Gaulard, M.D. (1) Laurence de Leval, M.D. Ph.D. (2) (1) Département de Pathologie, AP-HP, H?pital Henri Mondor, Créteil, France?; Universite Paris-Est, Faculté de Médecine, Créteil, France; INSERM U955, Créteil, France (2) Institute of Pathology, CHUV, University of Lausanne, Switzerland; Supported in part by grants from the Fondation pour la Recherche Médicale (FRM) Address correspondence: Philippe Gaulard Département de Pathologie H?pital Henri Mondor 51 Avenue du Maréchal de Lattre de Tassigny 94010 - Créteil France Tel: + 33 1 498 12?743?; Fax?: + 33 1 498 12?743? Email: philippe.gaulard@hmn.aphp.fr  Abstract A distinct subset of T helper cells, named follicular T helper cells (TFH), has been recently described. TFH cells are characterized by their homing capacities in the germinal centres of B-cell follicles where they interact with B cells, supporting B-cell survival and antibody responses. TFH cells can be identified by the expression of several markers including the chemokine CXCL13, the co-stimulatory molecules PD1 and ICOS, and the transcription factor BCL6. They appear to be relevant markers for the diagnosis of angioimmunoblastic T-cell lymphoma (AITL) and have helped to recognize subsets of peripheral T-cell lymphoma, NOS with nodal or cutaneous presentation expressing TFH antigens that might be related to AITL. In B-cell neoplasms, TFH cells are present within the microenvironment of nodular lymphocyte-predominant Hodgkin lymphoma and follicular lymphoma where they likely support the growth of neoplastic germinal centre-derived B cells. Interestingly, the amount of PD1+ cells in the neoplastic follicles might have a favourable impact on the outcome of FL patients. Altogether, the availability of antibodies directed to TFH -associated molecules has important diagnostic and prognostic implications in haematopathology. In addition, TFH cells could represent interes