Grywalska Ewelina, Bartkowiak-Emeryk Małgorzata, Pasiarski Marcin, Olszewska-Bożek Karolina, Mielnik Michał, Podgajna Martyna, Pieczykolan Monika, Hymos Anna, Fitas Elżbieta, Surdacka Agata, Góźdź Stanisław, Roliński Jacek
Department of Clinical Immunology and Immunotherapy, Medical University of Lublin, Poland.
Department of Hematology, Holycross Cancer Center, Kielce, Poland.
Adv Clin Exp Med. 2018 Jul;27(7):987-999. doi: 10.17219/acem/74437.
Chronic lymphocytic leukemia (CLL) is a condition characterized by the accumulation of morphologically mature monoclonal lymphocytes B with the CD19+/CD5+/CD23+ phenotype in lymphoid tissue, peripheral blood and bone marrow. The clinical course of patients with CLL is heterogeneous, ranging from indolent to aggressive. The role of lymphocyte activation in the natural history of CLL is still a matter of discussion.
The aim of this study was to determine the percentages and absolute numbers of lymphocytes B and T in peripheral blood and bone marrow of CLL patients. Moreover, we analyzed the relationship between the number of CD25-positive and CD69-positive lymphocytes and the established prognostic factors in CLL.
The study included 80 untreated patients with CLL and 20 healthy subjects. The immunophenotype of peripheral blood mononuclear cells (in both groups) and bone marrow cells (solely in the CLL group) was determined by means of flow cytometry.
Patients with CLL showed a higher absolute number of activated lymphocytes B with phenotypes CD19+CD25+ and CD19+CD69+, as well as a higher absolute number of CD3+CD25+ lymphocytes T than the controls. The enhanced activation of peripheral blood and bone marrow lymphocytes was associated with higher Rai stages, an increased concentration of lactate dehydrogenase and beta-2 microglobulin and the progression of the disease. The number of lymphocytes B CD19+ZAP-70+ correlated positively with the number of CD19+CD25+ B cells and CD3+CD69+ T cells.
The study confirmed the association between an unfavorable prognosis and a high expression of activation markers in CLL patients. The determination of CD25+ and CD69+ lymphocytes T and B constitutes a valuable diagnostic tool, completing the cytometric evaluation of CLL.
慢性淋巴细胞白血病（CLL）是一种以形态学成熟的单克隆B淋巴细胞在淋巴组织、外周血和骨髓中积聚为特征的疾病，其表型为CD19+/CD5+/CD23+。CLL患者的临床病程具有异质性，从惰性到侵袭性不等。淋巴细胞激活在CLL自然病程中的作用仍存在争议。
本研究旨在确定CLL患者外周血和骨髓中B淋巴细胞和T淋巴细胞的百分比及绝对数量。此外，我们分析了CD25阳性和CD69阳性淋巴细胞数量与CLL既定预后因素之间的关系。
该研究纳入了80例未经治疗的CLL患者和20名健康受试者。通过流式细胞术测定外周血单个核细胞（两组均测）和骨髓细胞（仅CLL组测）的免疫表型。
与对照组相比，CLL患者具有表型CD19+CD25+和CD19+CD69+的活化B淋巴细胞的绝对数量更高，以及CD3+CD25+ T淋巴细胞的绝对数量更高。外周血和骨髓淋巴细胞的活化增强与更高的Rai分期、乳酸脱氢酶和β2微球蛋白浓度升高以及疾病进展相关。CD19+ZAP-70+ B淋巴细胞数量与CD19+CD25+ B细胞和CD3+CD69+ T细胞数量呈正相关。
该研究证实了CLL患者预后不良与活化标志物高表达之间的关联。测定CD25+和CD69+ T淋巴细胞和B淋巴细胞构成了一种有价值的诊断工具，完善了CLL的细胞计量评估。
