Lymphoma: Looking for Clues in the Immune System

In lymphoma, the non-cancer cells in a tumor — known as the tumor microenvironment — play an important role in the course of the disease.

“Tumors don’t grow by themselves in the body,” explains Wilmot hematopathologist Richard Burack, M.D., Ph.D. “They have a lot of other cells mixed in with them, and the non-malignant part of a tumor is a powerful determinant of how these tumors will behave.”

Lymphoma is a cancer of the immune system, and it happens that the lymphoma’s microenvironment is made up of other immune cells. Its composition can influence the course of a patient’s disease and how patients respond to treatment. To analyze these cells and their role, Burack has teamed up with Tim Mosmann, Ph.D., who directs the University of Rochester Medical Center’s Human Immunology Center and David H. Smith Center for Vaccine Biology and Immunology.

They are testing if the type and number of immune cells in the blood predict the immune cells of the lymphoma’s microenvironment. Because the type and number of the immune cells in the microenvironment predicts how well immunotherapeutics work, their approach could potentially give doctors the information they need to personalize therapies.

Burack and Mosmann are also analyzing the microenvironment to understand more about what makes immunotherapies for lymphoma work.

“We don’t know if the efficacy of immunotherapies is based on the immune composition of the tumor or if it’s based on the patient’s overall immune status,” Burack says. “If we understand the relationship between the patient’s global immune system and the occurrence or recurrence of their lymphoma, we may have another marker to follow in patients that will tell us when start or reinitiate therapy.”