[Relationship of the Changes of Peripheral Blood Immuno-Cell Subsets with the Prognosis of B Cell Lymphoma Patients].

OBJECTIVE

To investigate the relationship of T lymphocyte subsets, B lymphocytes and NK cells with the genesis, progression and prognosis of B cell lymphoma.

METHODS

The levels of T lymphocyte subsets, B lymphocytes and NK cells in peripheral blood of healthy control group and B cell lymphoma group were detected by flow cytometry (FCM). The clinical data were collected, and the relationship of these immune indexes with the general conditions, laboratory indexes, curative effect and prognosis were analyzed.

RESULTS

Forty-four patients entolled in this study including 24 male and 20 females with the median age of 57 years old (17-82 years), all the patients were the first visit to our hospital and diagnosed. The total counts of lymphocytes, T, B and NK cells in the peripheral blood of patients with the first treatment of B-cell lymphoma were significantly lower than those in healthy controls, and the ratio of CD3HLA-DR activated T cells was significantly higher than that of healthy controls (<0.05). In the newly diagnosed patients, the levels of total lymphocytes, total T cells, total B cells, CD4 cells and NK cells in peripheral blood of patients with complete remission (CR) were higher than those in patients without complete remission ［partial remission (PR) and disease progression（PD）］ (<0.01, <0.01, <0.05, <0.01, <0.05, respectively). The logistic regression analysis showed that NK cells, FAC-1（FAC-1 is a component factor for linear regression of total lymphocytes, total T cells, and total B cells）, the ECOG score and β2-microglobulin level were significantly different between CR group and PR+SD group (<0.05, <0.01, <0.05, <0.01, respectively), among which ECOG score and β2-microglobulin were independent risk factor respectively for the prognosis of patients. The NK cells and FAC-1 were the protective factors for the prognosis of patients. The survival analysis performed according to the NK cell level of patients at initial diagnosis, the Kaplan-Meier survival curve found that the overall survival (OS) of the 2 groups was significantly different (<0.01), the survial rate in patients with NK cell absolute count> 61.5 /μl was higher than that in patients with low level of NK cells.

CONCLUSION

The level of total lymphocytes, total T cells, total B cells, NK cells and advanced activated T cells in the patients with B cell lymphoma were significantly different from those in normal subjects. Total count of lymphocytes, T cells, B cells, CD4 cells and NK cells in peripheral blood are important prognostic indicators for BCL. The ECOG score and β2-microglobulin level are independent risk factors for prognosis. The NK cell level and FAC-1 are independent protective factors for the prognosis of B cell lymphoma.