Zhang Zhan-Fang, Zhang Qiu-Tang, Xin Hai-Zhou, Gan Si-Lin, Ma Jie, Liu Yan-Fang, Xie Xin-Sheng, Sun Hui
Department of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China.
Department of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China. E-mail:
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2015 Aug;23(4):930-4. doi: 10.7534/j.issn.1009-2137.2015.04.004.
To explore the expression of PD-L1 in acute leukemia patients, and to analyze the relationship of PD-L1 expression with the patients' clinical characteristics and prognosis.
The expression of PD-L1 in leukemia cells of 75 patients including 59 de novo patients and 16 relapse/refractory patients with acute leukemia was detected by the flow cytometry, the clinical information was collected, and the therapeutic efficacy of de novo patients was analyzed.
The PD-L1 was expressed in human acute leukemia cells with total expression rate 32% (24/75), and its expression level in AML-M5 was higher than that in other leukemias [56.3% (9/16) vs 25.4% (15/59)], there was statistical significance (P = 0.019). The PD-L1 possitive rate in relapse/refractory group was higher than that in de novo patient group [(56.3% (9/16) vs 25.4% (15/59)], and there was statistical significance (P = 0.019). In 59 de novo patients, the CR rate of PD-L1 positive group after 1 course of chemotherapy was lower than that in PD-L1 negative group (66.7% vs 71.4%), the CR rate of PD-L1 positive group after 2 courses of chemotherapy was also lower than that in PD-L1 negative group (70% vs 88.6%). The relapse rate and the proportion of refractory patients in PD-L1 possitive group were higher than those in PD-L1 negative group. The expression of PD-L1 did not correlated with the clinical parameters, such as sex, age, extramedullary infiltration, percentage of blast cells in bone marrow, counts of WBC, RBC and platelet, as well as molecular biological features and cytogenetical characteristics.
PD-L1 is expressed in human acute leukemia cells, and may be involved in the immune escape and primary resistant mechanisms, PD-L1 may be used as an indicator for evaluation of the the patients' prognosis and reocurrence.
探讨急性白血病患者中程序性死亡受体配体1（PD-L1）的表达情况，并分析其表达与患者临床特征及预后的关系。
采用流式细胞术检测75例急性白血病患者（其中初发患者59例，复发/难治性患者16例）白血病细胞中PD-L1的表达，收集临床资料，并分析初发患者的治疗疗效。
人急性白血病细胞中存在PD-L1表达，总表达率为32%（24/75），其在急性单核细胞白血病（AML-M5）中的表达水平高于其他白血病[56.3%（9/16）对25.4%（15/59）]，差异有统计学意义（P = 0.019）。复发/难治组的PD-L1阳性率高于初发患者组[（56.3%（9/16）对25.4%（15/59）]，差异有统计学意义（P = 0.019）。在59例初发患者中，PD-L1阳性组化疗1个疗程后的完全缓解（CR）率低于PD-L1阴性组（66.7%对71.4%），化疗2个疗程后PD-L1阳性组的CR率也低于PD-L1阴性组（70%对88.6%）。PD-L1阳性组的复发率和难治患者比例高于PD-L1阴性组。PD-L1的表达与性别、年龄、髓外浸润、骨髓原始细胞百分比、白细胞、红细胞及血小板计数等临床参数以及分子生物学特征和细胞遗传学特征均无相关性。
PD-L1在人急性白血病细胞中表达，可能参与免疫逃逸及原发耐药机制，可作为评估患者预后及复发的指标。
