Division of Hematology, Japanese Red Cross Society Wakayama Medical Center, Wakayama, Wakayama, Japan.
Division of Pathology, Japanese Red Cross Society Wakayama Medical Center, Wakayama, Wakayama, Japan.
Int J Hematol. 2020 Jun;111(6):771-778. doi: 10.1007/s12185-020-02847-4. Epub 2020 Mar 11.
In the present study, we analyzed phenotypes of cells in the lymphocyte region of bone marrow in 68 patients with primary immune thrombocytopenia (ITP) to determine whether cellular phenotype predicts response to first-line therapy (corticosteroids or corticosteroids plus intravenous immunoglobulin). In 52 newly diagnosed ITP patients, an abnormal CD4:CD8 ratio (CD4/CD8 ratio < 0.4 and 2.3 < CD4/CD8 ratio) was noted in 22 patients in the responder group, whereas all non-responder and control individuals showed normal CD4:CD8 ratio (p < 0.001). The absolute number of CD19+ cells in patients with 0.4 ≤ CD4/CD8 ratio ≤ 2.3 or 2.3 < CD4/CD8 ratio was higher than that in other groups. (p = 0.016). In 16 chronic ITP patients, the absolute number of NK cells in the responder group was lower than those in the non-responder and control groups (p = 0.032). An abnormal CD4:CD8 ratio was noted in all patients in the responder group, whereas all patients in non-responder and control groups showed normal CD4:CD8 ratio (p < 0.001). The present results indicate that CD4:CD8 ratio, B cells, and NK cells contribute to the prediction of therapeutic outcomes of ITP patients.
在本研究中，我们分析了 68 例原发性免疫性血小板减少症（ITP）患者骨髓淋巴细胞区的细胞表型，以确定细胞表型是否预测一线治疗（皮质类固醇或皮质类固醇加静脉免疫球蛋白）的反应。在 52 例新诊断的 ITP 患者中，应答组的 22 例患者存在异常的 CD4:CD8 比值（CD4/CD8 比值<0.4 和 2.3<CD4/CD8 比值），而所有无应答者和对照组个体的 CD4:CD8 比值均正常（p<0.001）。0.4≤CD4/CD8 比值≤2.3 或 2.3<CD4/CD8 比值患者的 CD19+细胞绝对数高于其他组。（p=0.016）。在 16 例慢性 ITP 患者中，应答组 NK 细胞的绝对数低于无应答组和对照组（p=0.032）。应答组的所有患者均存在异常的 CD4:CD8 比值，而无应答组和对照组的所有患者均显示正常的 CD4:CD8 比值（p<0.001）。本研究结果表明，CD4:CD8 比值、B 细胞和 NK 细胞有助于预测 ITP 患者的治疗效果。
