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中国生物工程杂志

China Biotechnology
China Biotechnology
China Biotechnology  2019, Vol. 39 Issue (9): 50-57    DOI: 10.13523/j.cb.20190907
Orginal Article     
Prognostic Significance of Peripheral Blood Lymphocyte Subsets in Patients with Hematologic Malignancies
RAN Long-rong,XUE Ning,WANG Jian-rong,DU Ying-jian,MAO Jin-ju,ZHOU Quan-you YANG Zai-lin
Department of Laboratory Medicine, The Third Affiliated Hospital of Chongqing Medical University(Gener Hospital), Chongqing 401120, China
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Abstract  

Objective: To investigate the effect of peripheral blood lymphocyte subsets and clinical characteristics on the prognosis of hematologic malignancies.Methods: The peripheral blood lymphocyte subsets of 64 patients with newly diagnosed hematologic malignancy were detected by flow cytometry. Diseases included Acute myeloid leukemia (AML)、Acute lymphoblastic leukemia (ALL)、Hodgkin’s lymphoma (HL)、non-Hodgkin’s lymphoma as bone marrow infiltration (NHL). We analyzed the difference of peripheral blood lymphocyte subsets between 30 normal patients and the experimental group. And We analyzed the relationship between the changes of peripheral blood lymphocyte subsets and prognosis in 21 patients with acute leukemia who underwent continuous dynamic monitoring in 64 patients with malignant hematological diseases.Results: No significant difference was shown in lymphocyte subsets among different age groups of adult patients with malignant hematopathy. The percentage of CD3 +CD8 + T lymphocytes and T-reg cells in patients with malignant hematopathy increased, while the percentages of CD16 +/CD56 +NK cells, and CD4 +/CD8 + ratio were all decreased. The number of CD3 +T lymphocyte, CD3 +CD4 + lymphocyte, CD3 +CD8 + lymphocyte, CD19 + lymphocytes, CD16 +/CD56 + lymphocyte and CD4 +/CD8 + ratio were all decreased. There were some differences in peripheral blood lymphocyte subsets between acute leukemia and malignant lymphoma patients and control group. The proportion of T-reg cells in non-remission group of acute leukemia was significantly higher than that in remission group of first course of treatment of acute leukemia and control group. The proportion of T-reg cells in relapsed acute leukemia group was remarkably higher than that in sustained remission group and control group. In 21 patients with acute leukemia, we found that T-reg cells in remission group gradually decreased during chemotherapy and gradually approached the control group during the third to sixth courses of treatment. T-reg cells in non-remission group increased gradually or continued to exceed 10% in the course of chemotherapy, which was significantly higher than remission group. Furthermore, T-reg cells shown a trend of first subtraction and then addition during the chemotherapy in recurrence patients. Conclusion: The immune function of patients with malignant hematological diseases is significantly lower than that of healthy people, and accompanied by immune dysfunction. In addition, different types of diseases and different disease states brought about different degrees of immune disorders.the proportion of T-reg cells can be used to predict the curative effect and recurrence in patients with hematologic malignancies, for providing guidance basis for clinical treatment and medication intensity.



Key words： Lymphocyte subsets      Malignant hematological disease      Clinical prognosis     
Received: 12 September 2019      Published: 20 September 2019
ZTFLH:  Q291  
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Long-rong RAN
Ning XUE
Jian-rong WANG
Ying-jian DU
Jin-ju MAO
Quan-you YANG Zai-lin ZHOU
Cite this article:

RAN Long-rong,XUE Ning,WANG Jian-rong,DU Ying-jian,MAO Jin-ju,ZHOU Quan-you YANG Zai-lin. Prognostic Significance of Peripheral Blood Lymphocyte Subsets in Patients with Hematologic Malignancies. China Biotechnology, 2019, 39(9): 50-57.

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https://manu60.magtech.com.cn/biotech/10.13523/j.cb.20190907     OR     https://manu60.magtech.com.cn/biotech/Y2019/V39/I9/50

年龄 CD3(%) CD4(%) CD8(%) CD4/CD8 Treg(%) CD19(%) CD16+56(%)
≥60岁 70.90±8.67 35.21±14.96 34.21±14.92 1.05±0.63 8.76±4.25 12.47±5.74 12.45±9.02
<60岁 71.12±9.02 34.78±13.65 35.21±15.36 0.97±0.45 8.31±5.36 13.13±5.24 12.97±7.69
Table 1 Changes of lymphoid subsets in patients with malignant hematopathy at different ages
分组 CD3(%) CD4(%) CD8(%) CD4/CD8 Treg(%) CD19(%) CD16+56(%)
患者组 70.12±10.68 34.12±13.78 34.36±15.87* 1.02±0.68* 8.51±2.17* 13.63±4.31 12.64±5.01*
对照组 71.67±7.64 37.54±6.13 26.71±6.71 1.54±0.67 6.76±2.01 12.26±4.10 15.37±4.40
Table 2 The percentage of peripheral blood lymphocyte subsets in patients with newly diagnosed malignant hematopathy was compared with that in control group
分组 CD3 CD4 CD8 CD19 CD16+56
患者组 779.65±413.53* 389.83±228.13* 361.26±192.16* 88.76±39.47* 187.63±92.47*
对照组 1239.10±314.56 656.09±207.90 452.89±157.69 219.03±113.12 252.76±129.75
Table 3 The absolute count of peripheral blood lymphocyte subsets in patients with malignant hematopathy was compared with that in control group
分组 n CD3(%) CD4(%) CD8(%) CD4/CD8 Treg(%) CD19(%) CD16+56(%)
AML 28 68.01±18.79 34.62±4.95 31.24±7.58* 1.09±0.51* 9.23±3.33* 12.34±7.17 14.58±7.10
ALL 15 67.62±21.34 26.84±6.56* 38.42±10.69* 0.87±0.46* 9.62±4.45* 14.45±7.86 6.31±4.51*
HL 6 72.45±14.87 31.25±11.65* 33.25±8.61* 1.02±0.59* 7.36±4.30 12.61±3.53 13.36±4.60
NHL 15 71.36±16.54 30.69±12.46* 41.36±13.65* 0.78±0.62* 7.56±4.62 14.35±3.63 16.71±4.29
对照组 30 71.67±7.64 37.54±6.13 26.71±6.71 1.54±0.67 6.76±2.01 12.26±4.10 15.37±4.40
Table 4 Changes in the proportion of peripheral blood lymphocyte subsets in patients with different malignant hematopathy
Fig.1 Comparison of lymphocyte subsets between AML patients and ALL patients The X-axis represents the type of the lymphocyte subsets, and the Y-axis represents the proportion of the lymphcyte subsets * P<0.05
Fig.2 Lymphocyte subsets were compared between the HL patient group and the NHL patient group The X-axis represents the type of the lymphocyte subsets, and the Y-axis represents the proportion of the lymphocyte subsets * P<0.05
分组 n CD3(%) CD4(%) CD8(%) CD4/CD8 Treg(%) CD19(%) CD16+56(%)
首缓解组 22 71.72±11.65 36.46±13.29 33.43±5.83 1.20±0.58 7.06±2.96 11.68±6.01 15.67±6.31
未缓解组 13 69.23±12.30 34.62±15.27 31.89±8.56 1.12±0.74 9.37±2.81*# 13.12±5.39 14.36±5.68
对照组 30 71.67±7.64 37.54±6.13 26.71±6.71 1.54±0.67 6.76±2.01 12.26±4.10 15.37±4.40
Table 5 Comparison of lymphocyte subsets in patients with acute leukemia treated with different initial therapeutic effects
分组 n CD3(%) CD4(%) CD8(%) CD4/CD8 Treg(%) CD19(%) CD16+56(%)
持续缓解组 19 69.27±11.59 35.21±9.87 28.67±5.01 1.33±0.56 7.19±2.24 12.08±4.28 15.67±4.60
复发组 5 68.69±14.17 34.36±11.26 29.35±7.89 1.19±0.81 9.56±2.31*# 11.56±3.84 14.39±5.61
对照组 30 71.67±7.64 37.54±6.13 26.71±6.71 1.54±0.67 6.76±2.01 12.26±4.10 15.37±4.40
Table 6 Comparison of lymphocyte subsets in patients with acute leukemia in the continuous remission group and the relapse group
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