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急性髓系白血病和骨髓增生异常综合征中的自然杀伤细胞(NK)亚群及NK样T细胞群体

Natural killer cell (NK) subsets and NK-like T-cell populations in acute myeloid leukemias and myelodysplastic syndromes.

作者信息

Aggarwal N, Swerdlow S H, TenEyck S P, Boyiadzis M, Felgar R E

机构信息

Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.

Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.

出版信息

Cytometry B Clin Cytom. 2016 Jul;90(4):349-57. doi: 10.1002/cyto.b.21349. Epub 2016 Feb 3.

Abstract

The impact of the immune microenvironment on the behavior and therapeutic strategies for hematopoietic and lymphoid neoplasms is being increasingly recognized. Many functional studies of natural killer (NK) cell cytotoxic responses in myelodysplasia (MDS) and acute myeloid leukemia (AML) exist, but with limited data on these lymphocyte proportions and related T-cell subsets. The proportions of these cells and their prognostic implications were therefore investigated in 89 AML, 51 MDS, and 20 control marrows by flow cytometry. The median proportion of NK cells (relative to the total lymphocytes) was lower in AML versus controls (P = 0.01). Among AML, a lower proportion of NK cells predicted better survival, whereas a higher NK cell proportion was associated with the poor prognostic AML category (P = 0.002). NK cell proportions were similar in MDS, MDS subgroups, and control marrows. The relative proportion of the mature NK cell subset (CD56(dim) CD16/57(bright) ) was lower in AML and MDS versus controls (P = 0.006, P = 0.0002, respectively). The proportion of mature NK cells was not a prognostic indicator although fewer were seen in poor prognosis AML. In contrast, a lower proportion of mature NK cells correlated with worse survival in MDS (P = 0.027). A higher proportion of NK-like T-cells (of total lymphoid cells) was found in MDS compared to controls (P = 0.01). A lower proportion of NK-like T-cells predicted better survival in AML but not in MDS. Thus, the proportions of NK, NK-cell subsets, and NK-like T-cells vary in myeloid neoplasms, may potentially impact immunomodulatory therapies, and may impact outcome. © 2016 International Clinical Cytometry Society.

摘要

免疫微环境对造血和淋巴系统肿瘤的行为及治疗策略的影响正日益受到认可。目前已有许多关于骨髓增生异常综合征(MDS)和急性髓系白血病(AML)中自然杀伤(NK)细胞细胞毒性反应的功能研究,但关于这些淋巴细胞比例及相关T细胞亚群的数据有限。因此,我们通过流式细胞术对89例AML、51例MDS和20例对照骨髓中的这些细胞比例及其预后意义进行了研究。与对照组相比,AML中NK细胞(相对于总淋巴细胞)的中位数比例较低(P = 0.01)。在AML患者中,NK细胞比例较低预示着更好的生存率,而较高的NK细胞比例与预后不良的AML类别相关(P = 0.002)。MDS、MDS亚组和对照骨髓中的NK细胞比例相似。与对照组相比,AML和MDS中成熟NK细胞亚群(CD56(dim) CD16/57(bright) )的相对比例较低(分别为P = 0.006,P = 0.0002)。成熟NK细胞的比例不是一个预后指标,尽管在预后不良的AML中可见较少。相反,成熟NK细胞比例较低与MDS患者较差的生存率相关(P = 0.027)。与对照组相比,MDS中NK样T细胞(占总淋巴细胞的比例)的比例较高(P = 0.01)。较低比例的NK样T细胞预示着AML患者更好的生存率,但在MDS中并非如此。因此,NK、NK细胞亚群和NK样T细胞的比例在髓系肿瘤中有所不同,可能会潜在影响免疫调节治疗,并可能影响预后。© 2016国际临床细胞计量学会

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