Department of Internal Medicine, Hematology Unit, Tanta University, Faculty of Medicine, Tanta, Gharbiah, P.O 31527, Egypt.
Clinical Pathology Department, Tanta University, Faculty of Medicine, Tanta, Gharbiah, P.O 31527, Egypt.
Blood Cells Mol Dis. 2021 Mar;87:102529. doi: 10.1016/j.bcmd.2020.102529. Epub 2020 Dec 8.
Myeloid-Derived Suppressor Cells (MDSCs) are used as markers for short-term immune thrombocytopenia (ITP) course. This study aimed to assess their reliability to predict the sustained treatment response within 6 months.
We tested the sensitivity and specificity of MDSCs and proposed cut-off MDSCs values to predict the prognosis in newly diagnosed ITP. We enrolled 80 adults with primary ITP; 50 newly diagnosed (group I), 30 chronic (group II), and 20 controls (group III). Flow cytometry was used for peripheral blood MDSCs estimation with correlation, sensitivity, and specificity of MDSCs to predict sustained treatment response.
After 6 days and 6 months of treatment, MDSCs were significantly higher than pre-treatment in group I, (P < 0.001, P < 0.001). MDSCs were significantly higher in group I compared to groups II and III, (P < 0.001 for both). Cut-off values were 15.75% and >5.9% at 6 days and 6 months respectively. MDSCs sensitivity was 85.7% and 100% and specificity was 94.44% and 100% at 6 days and 6 months.
MDSCs may constitute a reliable predictor for ITP initial and prolonged treatment response with good sensitivity and specificity. This may guide the use of a specific therapeutic agent as maintenance therapy or its replacement in practice.
髓系来源抑制细胞（MDSCs）被用作短期免疫性血小板减少症（ITP）病程的标志物。本研究旨在评估其预测 6 个月内持续治疗反应的可靠性。
我们测试了 MDSCs 的灵敏度和特异性，并提出了 MDSCs 的截止值来预测新诊断 ITP 的预后。我们纳入了 80 名成人原发性 ITP 患者；50 名新诊断患者（I 组）、30 名慢性患者（II 组）和 20 名对照组（III 组）。采用流式细胞术检测外周血 MDSCs，评估 MDSCs 预测持续治疗反应的相关性、灵敏度和特异性。
治疗 6 天和 6 个月后，I 组患者的 MDSCs 明显高于治疗前（P<0.001，P<0.001）。与 II 组和 III 组相比，I 组患者的 MDSCs 明显更高（均 P<0.001）。6 天和 6 个月的截止值分别为 15.75%和>5.9%。6 天和 6 个月时，MDSCs 的灵敏度分别为 85.7%和 100%，特异性分别为 94.44%和 100%。
MDSCs 可能是 ITP 初始和长期治疗反应的可靠预测指标，具有良好的灵敏度和特异性。这可能有助于指导在实践中使用特定的治疗药物作为维持治疗或替代治疗。
