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  • 黄方,郝思国*.急性髓系白血病患者外周血T淋巴细胞亚群的水平变化及临床意义[J].第二军医大学学报,2020,41(5):546-550    [点击复制]
  • HUANG Fang,HAO Si-guo*.Changes of T lymphocyte subset levels in peripheral blood of acute myeloid leukemia patients and the clinical significance[J].Acad J Sec Mil Med Univ,2020,41(5):546-550   [点击复制]
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急性髓系白血病患者外周血T淋巴细胞亚群的水平变化及临床意义
黄方,郝思国*
0
(上海交通大学医学院附属新华医院血液科, 上海 200092
*通信作者)
摘要:
目的 检测急性髓系白血病(AML)患者外周血T淋巴细胞亚群水平的变化,并探讨其临床意义。方法 选择68例初诊AML患者及76例健康体检者(健康对照组)作为研究对象。根据《成人急性髓系白血病(非急性早幼粒细胞白血病)中国诊疗指南(2017年版)》对AML患者进行预后危险度分层,将患者分为高危组(20例)和非高危组(48例)。经标准化学治疗方案治疗后对AML患者进行疗效评价。采集AML患者及健康体检者外周血,用流式细胞术检测外周血T淋巴细胞亚群的水平。结果 AML患者外周血T淋巴细胞CD3+细胞比例、CD4+细胞比例及CD4+/CD8+细胞比值均低于健康对照组(P均<0.05),调节性T淋巴细胞(Treg细胞)比例高于健康对照组(P<0.05)。与非高危AML患者比较,高危AML患者外周血T淋巴细胞CD3+细胞比例、CD4+细胞比例及CD4+/CD8+细胞比值均降低(P均<0.05),Treg细胞比例升高(P<0.05)。与未获得完全缓解的AML患者(27例)比较,获得完全缓解的AML患者(41例)外周血T淋巴细胞CD3+细胞比例、CD4+细胞比例及CD4+/CD8+细胞比值均升高(P均<0.05),Treg细胞比例降低(P<0.05)。结论 观察AML患者T淋巴细胞亚群及CD4+/CD8+细胞比值变化有助于监测AML患者的病情。
关键词:  急性髓样白血病  T淋巴细胞  细胞免疫  预后
DOI:10.16781/j.0258-879x.2020.05.0546
投稿时间:2020-01-18修订日期:2020-03-02
基金项目:
Changes of T lymphocyte subset levels in peripheral blood of acute myeloid leukemia patients and the clinical significance
HUANG Fang,HAO Si-guo*
(Department of Hematology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
*Corresponding author)
Abstract:
Objective To detect the changes of T lymphocyte subset levels in peripheral blood of acute myeloid leukemia (AML) patients and explore the clinical significance. Methods Total of 68 newly diagnosed AML patients and 76 healthy candidates (healthy controls) were selected for the study. Prognostic risk stratification of AML patients was stratified according to Chinese guidelines for diagnosis and treatment of adult AML (not acute promyelocytic leukemia) (2017). The enrolled patients were divided into high-risk group (20 cases) and non-high-risk group (48 cases). The curative effect of AML patients was evaluated after standard chemotherapy. The flow cytometry technique was used to detect T lymphocyte subset levels in peripheral blood of the AML patients and the healthy controls. Results Proportions of CD3+, CD4+ T cells as well as CD4+/CD8+ ratio in AML group were significantly lower than those in healthy controls (all P<0.05), but the proportion of regulatory T (Treg) cells was significantly higher than that in healthy controls (P<0.05). The proportions of CD3+, CD4+ T cells and CD4+/CD8+ ratio in high-risk patients were significantly lower than those in non-high-risk patients (all P<0.05). The proportion of Treg cells in high-risk patients was significantly higher than that in non-high-risk patients (P<0.05). The proportions of CD3+, CD4+ T cells and CD4+/CD8+ ratio in patients who achieved complete remission (CR) (n=41) were significantly higher than those in patients without CR (n=27) (all P<0.05). However, the proportion of Treg cells in AML-CR patients was significantly lower than that in patients without CR (P<0.05). Conclusion Observation of T lymphocyte subsets and CD4+/CD8+ ratio can benefit to disease monitoring of patients with AML.
Key words:  acute myeloid leukemia  T-lymphocytes  cellular immunity  prognosis