Expression of cFLIP in B cells is essential for diffuse large B-cell lymphoma pathogenesis

K Kristie Tanavura Bariboloka (University of Cologne, Cologne, Germany) S Santiago Serrano-Saenz (University of Cologne, Cologne, Germany) D Deniz Pinar Savcigil (University of Cologne, Cologne, Germany) S Sarah Spoeck (Medical University of Innsbruck, Innsbruck, Austria) R Rebecca E. Poss (University Hospital Frankfurt am Main, Frankfurt am Main, Germany) L Luca D. Schreurs (University of Cologne, Cologne, Germany) J Jens Löber (Charité - University Medical Center Berlin, Berlin, Germany) N Nazli Serin (Department of Hematology, Oncology and Tumor Immunology, Charité University Medical Center) J Justinas Valiulis (University of Cologne, Cologne, Germany) K Kalvin Nugraha (University of Lausanne, Lausanne, Switzerland) G Giulia Gangarossa (University of Florence, Florence, Italy) A Anna Lütz M Moritz Reese S Sebastian Klein J Julius C. Enssle (Goethe University Frankfurt, University Hospital, Frankfurt, Germany) R Reinhard Büttner H Hamid Kashkar (Institute for Molecular Immunology, CECAD Research Center, University of Cologne, cologne, Germany) M Martin Peifer B Björn Chapuy (Department of Hematology, Oncology and Tumor Immunology, Charité University Medical Center) G Gero Knittel (1University Hospital Essen) V Verena Labi (Innsbruck Medical University, Innsbruck, Austria) A Andreas Villunger P Phuong-Hien Nguyen (University of Cologne) S Sebastian Scheich (Department of Medicine 2, Hematology/Oncology, University Medical Center Frankfurt, Goethe University) T Thomas Oellerich (Department of Medicine 2, Hematology/Oncology, University Medical Center Frankfurt, Goethe University) H Henning Walczak R Ruth Flümann (University Hospital Cologne, Cologne, Germany) R Ron D Jachimowicz (University Hospital of Cologne, Germany, Cologne, Germany) M Michael J Hallek (University of Cologne, Cologne, Germany) H Hans Christian Reinhardt A Alessandro Annibaldi

Abstract

Diffuse large B cell lymphoma (DLBCL) is a highly heterogenous malignant disease that remains a major clinical challenge as relapsed and refractory disease is difficult to treat. Apoptosis evasion is a major feature of DLBCL. However, while the suppression of intrinsic apoptosis has long been recognized as a lymphoma-promoting event, the role of extrinsic apoptosis has remained poorly defined. Here, we demonstrated at the genetic level that expression of cFLIP, the most crucial, non-redundant inhibitor of extrinsic apoptosis, in B cells is necessary for the development of diffuse large B cell lymphoma (DLBCL) in an autochthonous murine model. Indeed, B cell-specific deletion of Cflar, the gene encoding for cFLIP, prevented lymphomagenesis mediated by oncogenic Myd88 and overexpression of BCL2. In human lymphoma cells, we showed that the absence of cFLIP sensitizes ABC- but not GCB DLBCL subtype cells to TRAIL- or LPS-induced, Caspase-8-mediated apoptosis. Furthermore, we unveiled a cell death-independent role of cFLIP in the suppression of pro-inflammatory cytokines at the transcriptional level, selectively in the ABC subtype.These results indicate that the suppression of intrinsic apoptosis can support lymphomagenesis only if extrinsic apoptosis is properly controlled. Moreover, licensing extrinsic apoptosis via cFLIP deletion can efficiently promote the death of DLBCL cells despite the suppression of the intrinsic pathway. Overall, these data provide the rationale for the development of cFLIP inhibitors for the treatment of ABC DLBCL and possibly other haematological cancers.

Article Details

Journal Blood
Volume / Issue Vol. 1, Issue 1
Published April 23, 2026
ISSN 0006-4971
Publisher Elsevier BV

Journal Info

Blood

Elsevier BV

ISSN: 0006-4971 Health Sciences

Authors (31)

K

Kristie Tanavura Bariboloka

University of Cologne, Cologne, Germany

S

Santiago Serrano-Saenz

University of Cologne, Cologne, Germany

D

Deniz Pinar Savcigil

University of Cologne, Cologne, Germany

S

Sarah Spoeck

Medical University of Innsbruck, Innsbruck, Austria

R

Rebecca E. Poss

University Hospital Frankfurt am Main, Frankfurt am Main, Germany

L

Luca D. Schreurs

University of Cologne, Cologne, Germany

J

Jens Löber

Charité - University Medical Center Berlin, Berlin, Germany

N

Nazli Serin

Department of Hematology, Oncology and Tumor Immunology, Charité University Medical Center

J

Justinas Valiulis

University of Cologne, Cologne, Germany

K

Kalvin Nugraha

University of Lausanne, Lausanne, Switzerland

G

Giulia Gangarossa

University of Florence, Florence, Italy

A

Anna Lütz

M

Moritz Reese

S

Sebastian Klein

J

Julius C. Enssle

Goethe University Frankfurt, University Hospital, Frankfurt, Germany

R

Reinhard Büttner

H

Hamid Kashkar

Institute for Molecular Immunology, CECAD Research Center, University of Cologne, cologne, Germany

M

Martin Peifer

B

Björn Chapuy

Department of Hematology, Oncology and Tumor Immunology, Charité University Medical Center

G

Gero Knittel

1University Hospital Essen

V

Verena Labi

Innsbruck Medical University, Innsbruck, Austria

A

Andreas Villunger

P

Phuong-Hien Nguyen

University of Cologne

S

Sebastian Scheich

Department of Medicine 2, Hematology/Oncology, University Medical Center Frankfurt, Goethe University

T

Thomas Oellerich

Department of Medicine 2, Hematology/Oncology, University Medical Center Frankfurt, Goethe University

H

Henning Walczak

R

Ruth Flümann

University Hospital Cologne, Cologne, Germany

R

Ron D Jachimowicz

University Hospital of Cologne, Germany, Cologne, Germany

M

Michael J Hallek

University of Cologne, Cologne, Germany

H

Hans Christian Reinhardt

A

Alessandro Annibaldi