Bae Mi-Hyun, Park Chan-Jeoung, Suh Cheolwon
Department of Laboratory Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri 11923, Korea.
Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul 05505, Korea.
J Clin Med. 2021 Oct 14;10(20):4717. doi: 10.3390/jcm10204717.
Myeloid-derived suppressor cells (MDSCs) are heterogeneous populations of immature myeloid cells with immunosuppressive effects that have prognostic potential in patients with malignancies; however, survival analysis studies are sparse. In this study, the prognostic implication of MDSCs was investigated in peripheral blood (PB) and bone marrow (BM) samples from 81 patients with plasma cell myeloma at diagnosis. MDSCs were quantified as monocytic MDSCs (mMDSCs) (CD11bHLA-DRCD14) and granulocytic MDSCs with neutrophils (gMDSCs-N) (CD11bHLA-DRCD14CD33CD15). Serum creatinine and lactate dehydrogenase levels showed a moderate correlation with all MDSC types, except BM-gMDSCs-N; mMDSCs correlated with serum β2-microglobulin level, and PB-mMDSCs showed an inverse correlation with hemoglobin. PB-mMDSC levels were significantly higher in patients with progressive disease than those in patients at diagnosis and complete response. BM-mMDSC levels in patients with progressive disease were also higher than those in patients at diagnosis. Patients with high mMDSCs showed significantly poorer prognosis than patients with low mMDSCs. Multivariate analysis showed high PB-mMDSCs (≥0.3%) as a significant adverse prognostic marker for overall survival. This study demonstrated the independent adverse prognostic impact of PB-mMDSCs in patients with myeloma. PB-mMDSC measurement using whole blood is readily accessible in clinical laboratories, and may be used as a prognostic marker in clinical practice.
髓源性抑制细胞（MDSCs）是具有免疫抑制作用的未成熟髓样细胞的异质性群体，对恶性肿瘤患者具有预后潜力；然而，生存分析研究较少。在本研究中，我们对81例诊断时的浆细胞骨髓瘤患者的外周血（PB）和骨髓（BM）样本中MDSCs的预后意义进行了研究。MDSCs被定量为单核细胞MDSCs（mMDSCs）（CD11b+HLA-DR-CD14+）和粒细胞MDSCs与中性粒细胞（gMDSCs-N）（CD11b+HLA-DR-CD14+CD33+CD15+）。血清肌酐和乳酸脱氢酶水平与所有MDSC类型均呈中度相关，但BM-gMDSCs-N除外；mMDSCs与血清β2-微球蛋白水平相关，而PB-mMDSCs与血红蛋白呈负相关。进展性疾病患者的PB-mMDSC水平显著高于诊断时和完全缓解患者。进展性疾病患者的BM-mMDSC水平也高于诊断时患者。高mMDSCs患者的预后明显比低mMDSCs患者差。多因素分析显示，高PB-mMDSCs（≥0.3%）是总生存的显著不良预后标志物。本研究证明了PB-mMDSCs对骨髓瘤患者具有独立的不良预后影响。使用全血测量PB-mMDSC在临床实验室中很容易实现，可作为临床实践中的预后标志物。
