[初诊骨髓增生异常综合征患者自然杀伤细胞分布及其与预后的相关性]

[Distribution of Natural Killer Cell in Patients with Newly Diagnosed Myelodysplastic Syndromes and Its Correlation with Prognosis].

作者信息

Li Shan, Hong Ming, Zhang Jing-Jing, Fang Yu, Yang Li-Jia, Li Jian-Yong, Qian Si-Xuan

机构信息

Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu Province, China,Department of Hematology, The Third Affiliated Hospital of Sun-Yat Sen University, Guangzhou 510630, Guangdong Province, China.

Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu Province, China.

出版信息

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2020 Feb;28(1):196-201. doi: 10.19746/j.cnki.issn.1009-2137.2020.01.033.

DOI:10.19746/j.cnki.issn.1009-2137.2020.01.033

PMID:32027276

Abstract

OBJECTIVE

To investigate the distribution of peripheral blood lymphocytes and natural killer (NK) cells, and its influence on the prognosis of patients with myelodysplastic syndromes (MDS).

METHODS

The lymphocytes proportion, absolute lymphocyte counts (ALC), NK cell proportion and absolute NK cell counts (ANKC) as well as the related data of 95 MDS patients diagnosed between 2013 and 2017 analyzed retrospectively. The correlation of ALC and ANKC with prognosis was also analyzed.

RESULTS

As compared with low ALC patients, MDS patients with ALC≥0.885×10/L had a higher overall response rate (66.7% vs 35.8%) (P＜0.01). The ALC of effective patients after treatment significatitly increased in compaison of ALC at diagnosis. Multivariate analysis indicated that patients with ALC≥0.885×10/L had long overall survival (OS) time in comparison with patients with low level (16.4 vs 12.4 months) (P＜0.05). The OS time of patients with ANKC≥0.110×10/L was shorter in comparison with patients with low level (10.9 vs 16.3 months) (P＜0.01). Otherwise, blast, cytogenetic risks and treatment response were also independent risk factors of MDS (P＜0.05). Revised International Prognostic Scoring System (IPSS-R) combined with ANKC could improve predictive accuracy of IPSS-R alone (AUC 0.718 vs 0.674) (P＜0.05).

CONCLUSION

Lymphocytes and NK cells are important for the prognosis evaluation of MDS patients.

摘要

目的

探讨外周血淋巴细胞和自然杀伤（NK）细胞的分布情况及其对骨髓增生异常综合征（MDS）患者预后的影响。

方法

回顾性分析2013年至2017年期间诊断的95例MDS患者的淋巴细胞比例、淋巴细胞绝对计数（ALC）、NK细胞比例和NK细胞绝对计数（ANKC）以及相关数据。同时分析ALC和ANKC与预后的相关性。

结果

与ALC低的患者相比，ALC≥0.885×10⁹/L的MDS患者总缓解率更高（66.7%对35.8%）（P＜0.01）。治疗后有效患者的ALC较诊断时显著升高。多因素分析表明，ALC≥0.885×10⁹/L的患者与低水平患者相比总生存（OS）时间更长（16.4个月对12.4个月）（P＜0.05）。ANKC≥0.110×10⁹/L的患者与低水平患者相比OS时间更短（10.9个月对16.3个月）（P＜0.01）。此外，原始细胞比例、细胞遗传学风险和治疗反应也是MDS的独立危险因素（P＜0.05）。修订的国际预后评分系统（IPSS-R）联合ANKC可提高单独IPSS-R的预测准确性（AUC 0.718对0.674）（P＜0.05）。