不变自然杀伤 T 细胞数量低与急性髓系白血病患者的生存不良相关。
Low number of invariant NKT cells is associated with poor survival in acute myeloid leukemia.
机构信息
Departamento de Morfología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Prol. Carpio y Plan de Ayala S/N, Colonia Santo Tomás, Delegación Miguel Hidalgo, 11340, Mexico, DF, Mexico.
出版信息
J Cancer Res Clin Oncol. 2012 Aug;138(8):1427-32. doi: 10.1007/s00432-012-1251-x. Epub 2012 Jun 13.
BACKGROUND
T lymphocytes play an important role in the immunosurveillance of patients with hematologic malignancies. No study has so far examined the association between the number of lymphocyte subsets at diagnosis and overall survival (OS). We examined this relationship in adult patients with de novo acute myeloid leukemia (AML).
METHODS
A longitudinal prospective study was conducted on 28 AML patients. Peripheral blood (PB) and bone marrow (BM) were obtained before chemotherapy to quantify the number of CD4+ and CD8+ T cells, natural killer (NK), invariant NKT (iNKT), and type-1 and type-2 dendritic cells. The Kaplan-Meier and Cox proportional hazard model were used to determine significant association between the number of each cell subtype and survival.
RESULTS
BM counts of CD4+ lymphocytes >506.11/μL and CD8+ T lymphocytes >556.02/μL and a PB count of iNKT cells <0.2/μL were associated with poor OS by univariate analysis (P = 0.015, P = 0.009, P = 0.033 respectively). Multivariate analysis showed that an iNKT count <0.2 cells/μL is an independent prognostic factor for OS.
CONCLUSION
An iNKT cell number of <0.2/μL confers a poor prognosis in de novo AML patients.
背景
T 淋巴细胞在血液恶性肿瘤患者的免疫监视中发挥重要作用。迄今为止，尚无研究探讨诊断时淋巴细胞亚群数量与总生存期（OS）之间的关系。我们在初诊急性髓系白血病（AML）的成年患者中对此进行了研究。
方法
对 28 例 AML 患者进行了一项前瞻性纵向研究。在化疗前采集外周血（PB）和骨髓（BM），以定量测定 CD4+和 CD8+T 细胞、自然杀伤（NK）细胞、固有型自然杀伤 T（iNKT）细胞以及 1 型和 2 型树突状细胞的数量。采用 Kaplan-Meier 和 Cox 比例风险模型确定每种细胞亚型数量与生存之间的显著关联。
结果
单因素分析显示，BM 中 CD4+淋巴细胞计数>506.11/μL、CD8+T 淋巴细胞计数>556.02/μL 以及 PB 中 iNKT 细胞计数<0.2/μL 与 OS 较差相关（P=0.015、P=0.009、P=0.033）。多因素分析显示，iNKT 细胞计数<0.2 个/μL 是 OS 的独立预后因素。
结论
iNKT 细胞计数<0.2/μL 预示初诊 AML 患者预后不良。
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