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犬CD4+ T细胞淋巴瘤的流式细胞术特征及临床结果:67例病例

Flow cytometric characterization and clinical outcome of CD4+ T-cell lymphoma in dogs: 67 cases.

作者信息

Avery P R, Burton J, Bromberek J L, Seelig D M, Elmslie R, Correa S, Ehrhart E J, Morley P S, Avery A C

机构信息

Department of Microbiology, Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO; Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO.

出版信息

J Vet Intern Med. 2014 Mar-Apr;28(2):538-46. doi: 10.1111/jvim.12304. Epub 2014 Feb 3.

Abstract

BACKGROUND

Canine T-cell lymphoma (TCL) is conventionally considered an aggressive disease, but some forms are histologically and clinically indolent. CD4 TCL is reported to be the most common subtype of TCL. We assessed flow cytometric characteristics, histologic features when available, and clinical outcomes of CD4+ TCL to determine if flow cytometry can be used to subclassify this group of lymphomas.

OBJECTIVE

To test the hypothesis that canine CD4+ T-cell lymphoma (TCL) is a homogeneous group of lymphomas with an aggressive clinical course.

ANIMALS

Sixty-seven dogs diagnosed with CD4+ TCL by flow cytometry and treated at 1 of 3 oncology referral clinics.

METHODS

Retrospective multivariable analysis of outcome in canine CD4+ TCL including patient characteristics, treatment, and flow cytometric features.

RESULTS

The majority of CD4+ TCL were CD45+, expressed low class II MHC, and exhibited an aggressive clinical course independent of treatment regimen (median survival, 159 days). Histologically, CD4+ TCL were classified as lymphoblastic or peripheral T cell. Size of the neoplastic lymphocytes had a modest effect on both PFI and survival in this group. A small number of CD4+ TCL were CD45- and class II MHC high, and exhibited an apparently more indolent clinical course (median survival not yet reached).

CONCLUSIONS AND CLINICAL IMPORTANCE

Although the majority of CD4+ TCL in dogs had uniform clinical and flow cytometric features and an aggressive clinical course, a subset had a unique immunophenotype that predicts significantly longer survival. This finding strengthens the utility of flow cytometry to aid in the stratification of canine lymphoma.

摘要

背景

犬T细胞淋巴瘤(TCL)传统上被认为是一种侵袭性疾病,但某些形式在组织学和临床上表现为惰性。据报道,CD4 TCL是TCL最常见的亚型。我们评估了CD4⁺TCL的流式细胞术特征、可用时的组织学特征以及临床结局,以确定流式细胞术是否可用于对这组淋巴瘤进行亚分类。

目的

检验犬CD4⁺T细胞淋巴瘤(TCL)是一组具有侵袭性临床病程的同质淋巴瘤这一假设。

动物

67只通过流式细胞术诊断为CD4⁺TCL并在3家肿瘤转诊诊所之一接受治疗的犬。

方法

对犬CD4⁺TCL的结局进行回顾性多变量分析,包括患者特征、治疗和流式细胞术特征。

结果

大多数CD4⁺TCL为CD45⁺,表达低水平的II类主要组织相容性复合体(MHC),并且呈现出与治疗方案无关的侵袭性临床病程(中位生存期为159天)。在组织学上,CD4⁺TCL被分类为淋巴母细胞性或外周T细胞性。肿瘤淋巴细胞的大小对该组的无进展生存期(PFI)和生存期有适度影响。少数CD4⁺TCL为CD45⁻且II类MHC高表达,并呈现出明显更惰性的临床病程(中位生存期尚未达到)。

结论及临床意义

尽管犬的大多数CD4⁺TCL具有一致的临床和流式细胞术特征以及侵袭性临床病程,但有一个亚组具有独特的免疫表型,预示生存期明显更长。这一发现强化了流式细胞术在犬淋巴瘤分层中的应用价值。

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