Department of International Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China.
State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin, China.
Ann Med. 2022 Dec;54(1):2431-2439. doi: 10.1080/07853890.2022.2118367.
Idiopathic aplastic anaemia (IAA) is a heterogeneous autoimmune disease characterised by pancytopenia and bone marrow failure. The objective of the study was to investigate the clusters of lymphocyte subset in newly diagnosed IAA patients and explore their correlation with clinical characteristics.
A total of 124 newly diagnosed IAA patients were enrolled. Lymphocyte subset was detected by flow cytometry. Cluster analysis was conducted to identify subgroups of patients based on lymphocyte subset.
Cluster analysis classified patients into four distinctive subgroups: Cluster 1 (CD4 T cells dominant), Cluster 2 (CD8 T cells dominant), Cluster 3 (NK cells dominant) and Cluster 4 (B cells dominant). Patients in Clusters 1 and 4 suffered more severe disease status than ones in Clusters 2 and 3 ( = .013). And with it, patients in Cluster 2 had the highest white blood cell count, haemoglobin level, reticulocyte count and reticulocyte percentage, while patients in Cluster 3 had the lowest lymphocyte percentage and the highest neutrophil count (all < .05). Unexpectedly, patients in Cluster 3 tended to have superior curative effect than ones in other clusters, an ordinal logistic regression analysis further confirmed the independent correlation between Cluster 3 and good response to treatment. Lymphocyte subset clustering may serve as a biomarker for assessing disease severity and treatment efficacy in newly diagnosed IAA patients.Key MessagesNewly diagnosed IAA patients could be classified into 4 distinctive subgroups with similar immune patterns by using cluster analysis of lymphocyte subset.Clusters of lymphocyte subset were closely correlated with disease severity and treatment response of IAA.Lymphocyte subset clustering may serve as a promising tool for assessing disease severity and treatment efficacy in newly diagnosed IAA patients.
特发性再生障碍性贫血（IAA）是一种异质性自身免疫性疾病，其特征为全血细胞减少和骨髓衰竭。本研究的目的是探讨新诊断的 IAA 患者淋巴细胞亚群聚类及其与临床特征的相关性。
共纳入 124 例新诊断的 IAA 患者。采用流式细胞术检测淋巴细胞亚群。基于淋巴细胞亚群对患者进行聚类分析，以识别不同的患者亚群。
聚类分析将患者分为四个不同的亚群：簇 1（CD4 T 细胞占优势）、簇 2（CD8 T 细胞占优势）、簇 3（NK 细胞占优势）和簇 4（B 细胞占优势）。簇 1 和簇 4 的患者疾病状态比簇 2 和簇 3 更为严重（ = .013）。同时，簇 2 的患者白细胞计数、血红蛋白水平、网织红细胞计数和网织红细胞百分比最高，而簇 3 的患者淋巴细胞百分比最低、中性粒细胞计数最高（均 < .05）。出乎意料的是，簇 3 的患者治疗效果优于其他亚群，有序逻辑回归分析进一步证实了簇 3 与治疗反应良好之间的独立相关性。淋巴细胞亚群聚类可能是评估新诊断 IAA 患者疾病严重程度和治疗效果的生物标志物。
通过对淋巴细胞亚群进行聚类分析，新诊断的 IAA 患者可分为具有相似免疫模式的 4 个不同亚群。
淋巴细胞亚群聚类与 IAA 的疾病严重程度和治疗反应密切相关。
淋巴细胞亚群聚类可能是评估新诊断 IAA 患者疾病严重程度和治疗效果的有前途的工具。
