Cytologic Evaluation of Tumor-Infiltrating Lymphocytes for Adoptive Cell Therapy

Am J Clin Pathol. 2020 Mar 9;153(4):513-523. doi: 10.1093/ajcp/aqz195.

Abstract

Objectives: Novel immunotherapeutic options for refractory metastatic cancer patients include adoptive cell therapies such as tumor infiltrating lymphocytes (TILs). This study characterizes the clinicopathologic findings in a cohort of TIL specimens.

Methods: Patients with metastatic malignancy who were eligible had TILs from their metastases grown and expanded and then sent to pathology.

Results: A total of 11 TIL specimens (10 melanoma, 1 adenocarcinoma) from patients enrolled in an experimental clinical trial were reviewed. All specimens showed more than 200 lymphoid cells, stained positive for lymphoid markers confirming an activated cytotoxic T-cell immunophenotype, and morphologically showed an intermediate-sized population with immature chromatin and frequent mitoses. Six cases (55%) showed large cells with nucleomegaly and prominent nucleoli.

Conclusions: This report is the first describing cytopathologic findings of autologous TIL therapy including adequacy guidelines and expected cytomorphologic and immunophenotypic findings. To meet this novel clinical demand, a predefined cytology protocol to rapidly process and interpret these specimens needs to be established.

Keywords: Cellular therapy; Clinical trial; Culture; Cytology; Cytopathology; TIL; Tumor-infiltrating lymphocyte.

MeSH terms

  • Adenocarcinoma / pathology
  • Adenocarcinoma / therapy*
  • Adult
  • Female
  • Flow Cytometry
  • Humans
  • Immunophenotyping
  • Immunotherapy, Adoptive / methods*
  • Lymphocytes, Tumor-Infiltrating / pathology*
  • Male
  • Melanoma / pathology
  • Melanoma / therapy*
  • Middle Aged