Hematology Unit, Clinical Pathology Department, Faculty of Medicine, Mansoura University, Egypt.
Hematology Unit, Mansoura University Oncology Center, Faculty of Medicine, Mansoura University, Egypt.
Asian Pac J Cancer Prev. 2020 Aug 1;21(8):2225-2230. doi: 10.31557/APJCP.2020.21.8.2225.
This study was designed in order to identify the prognostic relevance of CD200 expression and soluble Cytotoxic T-lymphocyte antigen-4 (CTLA-4) levels in myelodysplastic syndrome (MDS) patients.
The study included 57 MDS (37 intermediate and 20 high risk) patients and 10 controls. For all of included patients; CD200 expression was identified by flowcytometry on CD33 positive cells and soluble CTLA-4 (CD152) concentration was determined by ELISA.
CD200 positive expression was detected in 32/57 (56.1%) of MDS cases, the mean serum CTLA-4 concentrations were significantly higher in MDS patients as compared to controls (P<0.01). Significant association between high CD200 positive expression; high CTLA-4 concentration levels and MDS risk stages being higher in high risk MDS group as compared to intermediate risk one (P < 0.01). After 36-month follow-up; the subgroup of MDS patients with high expression of CD200; and high serum CTLA-4 concentrations showed high death rate and high frequency of acute myeloid leukemia transformation.
CD200 positive expression could be considered as a new prognostic marker for risk stratification of MDS patients. CD200 expression may exert its effect through upregulation of CTLA-4.
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本研究旨在确定 CD200 表达和可溶性细胞毒性 T 淋巴细胞相关抗原 4（CTLA-4）水平在骨髓增生异常综合征（MDS）患者中的预后相关性。
方法：该研究纳入了 57 例 MDS（37 例中危和 20 例高危）患者和 10 名对照。对所有纳入的患者；通过流式细胞术在 CD33 阳性细胞上鉴定 CD200 表达，通过 ELISA 测定可溶性 CTLA-4（CD152）浓度。
结果：在 57 例 MDS 病例中，有 32/57（56.1%）检测到 CD200 阳性表达，MDS 患者的血清 CTLA-4 浓度明显高于对照组（P<0.01）。高 CD200 阳性表达与 MDS 风险分期之间存在显著相关性，高危 MDS 组的 CTLA-4 浓度水平高于中危 MDS 组（P<0.01）。在 36 个月的随访后；CD200 高表达和高血清 CTLA-4 浓度的 MDS 患者亚组死亡率较高，急性髓系白血病转化率较高。
结论：CD200 阳性表达可作为 MDS 患者风险分层的新预后标志物。CD200 的表达可能通过上调 CTLA-4 发挥作用。
