基于流式细胞术评估外周血淋巴细胞对新诊断弥漫性大B细胞淋巴瘤患者的预后价值

Flow-cytometry-based evaluation of peripheral blood lymphocytes in prognostication of newly diagnosed DLBCL patients.

作者信息

Rusak Małgorzata, Bołkun Łukasz, Chociej-Stypułkowska Joanna, Pawlus Joanna, Kłoczko Janusz, Dąbrowska Milena

机构信息

Department of Hematological Diagnostics, Medical University of Bialystok, Białystok, Poland.

Department of Hematology, Medical University of Bialystok, Białystok, Poland.

出版信息

Blood Cells Mol Dis. 2016 Jul;59:92-6. doi: 10.1016/j.bcmd.2016.04.004. Epub 2016 Apr 28.

DOI:10.1016/j.bcmd.2016.04.004

PMID:27282574

Abstract

AIMS

We aimed to analyse whether quantitative assessment of peripheral blood lymphocyte CD19(+)CD20(+)CD22(+)CD79a(+) B cells, CD3(+)CD4(+)CD5(+)CD8(+) T cells and CD4(+)CD25(+++)Foxp3high Treg can improve prognostication in DLBCL patients.

METHODS

The absolute count of lymphocytes, B-cells, T-cells and Treg-cells as well as the percentage of apoptotic cells were assessed by means of flow cytometry in all studied subjects.

RESULTS

Significantly lower level of ALC and the percentage of apoptotic cells have been observed exclusively in DLBCL patients with HR. We also showed, that in comparison with LR, in HR and MR groups, there is a significant decrease in the absolute number of T-cells and Tregs. The applied treatment does no normalize the number of B-cells, Tregs and apoptotic cells only in the case of HR patients.

CONCLUSIONS

Lymphopenia, the decreased absolute number of T cells, Tregs, and a percentage of apoptotic cells, correlates with clinical staging in DLBCL patients. The increased number of B cells and the decreased level of Tregs and apoptotic cells after treatment might predict a poor clinical outcome in patients treated with RCHOP. Thereby, flow-cytometry-based evaluation of peripheral blood lymphocytes may be useful in prognostication of newly diagnosed DLBCL patients.

摘要

目的

我们旨在分析对外周血淋巴细胞CD19(+)CD20(+)CD22(+)CD79a(+) B细胞、CD3(+)CD4(+)CD5(+)CD8(+) T细胞和CD4(+)CD25(+++)Foxp3高表达调节性T细胞进行定量评估是否能改善弥漫性大B细胞淋巴瘤（DLBCL）患者的预后。

方法

通过流式细胞术对所有研究对象的淋巴细胞、B细胞、T细胞和调节性T细胞的绝对计数以及凋亡细胞百分比进行评估。

结果

仅在具有高危（HR）特征的DLBCL患者中观察到绝对淋巴细胞计数（ALC）和凋亡细胞百分比显著降低。我们还表明，与低危（LR）组相比，HR组和中危（MR）组的T细胞和调节性T细胞绝对数量显著减少。仅在HR患者中，应用的治疗未能使B细胞、调节性T细胞数量和凋亡细胞数量恢复正常。

结论

淋巴细胞减少、T细胞和调节性T细胞绝对数量减少以及凋亡细胞百分比与DLBCL患者的临床分期相关。治疗后B细胞数量增加以及调节性T细胞和凋亡细胞水平降低可能预示接受利妥昔单抗联合环磷酰胺、多柔比星、长春新碱和泼尼松（RCHOP）治疗的患者临床结局不佳。因此，基于流式细胞术对外周血淋巴细胞进行评估可能有助于新诊断DLBCL患者的预后判断。