地西他滨和沙利度胺对骨髓增生异常综合征患者免疫效应及骨髓间充质干细胞的影响
Effect of decitabine and thalidomide on the immunological effect and bone marrow mesenchymal stem cells of patients with myelodysplastic syndrome.
作者信息
Xing Lina, Ren Jinhai, Guo Xiaonan, Qiao Shukai, Tian Tian
机构信息
Department of Hematology, Second Affiliated Hospital, Hebei Medical University Shijiazhuang 050000, Hebei Province, China.
出版信息
Am J Transl Res. 2021 Apr 15;13(4):2462-2471. eCollection 2021.
OBJECTIVE
This study intended to investigate the therapeutic effect of decitabine and thalidomide on myelodysplastic syndrome (MDS), immunological effect and effective mesenchymal stem cells (MSCs).
METHODS
Altogether 62 patients with MDS diagnosed in our hospital were selected. Patients who received 5-day treatment mainly and received decitabine from the 1 day to the 5 day were collected as group A (A), while patients who received thalidomide 1 to 5 day as in group A were collected as group B (B). The immunologic effects, blood and bone marrow index levels, clinical effects and adverse reactions of group A and group B before and after intervention were observed.
RESULTS
Th17 in the two groups after intervention were evidently lower than that before intervention, and the decrease of Th17 cells in group B after intervention was more obvious than that in group A (P<0.001). Th22 cells in the two groups after intervention were evidently down-regulated compared with those before intervention, and the down-regulation of Th17 cells in group B after intervention was more obvious than that in group A (P<0.001). However, compared with group A, the levels of CD3+, CD4+, CD4+/CD8+ in serum of group B increased more obviously and CD8+ decreased more obviously after intervention. The white blood cell count of group B after intervention was evidently higher than that of group A (P<0.001). The hemoglobin concentration after intervention in group B was evidently higher than that in group A (P<0.001). The platelet count after intervention in group A was evidently higher than that in group B (P<0.001). The total effective rate in group B was evidently higher than that in group A (P<0.05).
CONCLUSION
The combination of decitabine and thalidomide has a better regulatory role in the immunological mechanism and bone marrow mesenchymal stem cells of patients with MDS than the single decitabine therapy on the premise of ensuring clinical efficacy.
目的
本研究旨在探讨地西他滨和沙利度胺对骨髓增生异常综合征（MDS）的治疗效果、免疫效应及有效间充质干细胞（MSCs）。
方法
选取我院确诊的62例MDS患者。以主要接受5天治疗且从第1天至第5天接受地西他滨治疗的患者为A组（A），以与A组第1至5天接受相同剂量沙利度胺治疗的患者为B组（B）。观察A、B两组干预前后的免疫效应、血液及骨髓指标水平、临床疗效及不良反应。
结果
两组干预后Th17均明显低于干预前，且B组干预后Th17细胞下降幅度比A组更明显（P<0.001）。两组干预后Th22细胞均明显下调，且B组干预后Th17细胞下调幅度比A组更明显（P<0.001）。然而，与A组相比，B组干预后血清中CD3+、CD4+、CD4+/CD8+水平升高更明显，CD8+下降更明显。B组干预后的白细胞计数明显高于A组（P<0.001）。B组干预后的血红蛋白浓度明显高于A组（P<0.001）。A组干预后的血小板计数明显高于B组（P<0.001）。B组的总有效率明显高于A组（P<0.05）。
结论
在地西他滨单药治疗保证临床疗效的前提下，地西他滨与沙利度胺联合应用对MDS患者的免疫机制及骨髓间充质干细胞具有比单用地西他滨更好的调节作用。
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