在儿童B系急性淋巴细胞白血病中，较高的基线自然杀伤细胞计数与较低的8天原始细胞计数及较低的第33天微小残留病相关。
Higher baseline natural killer cell counts are associated with a lower 8-day blast count and lower day 33 minimal residual disease in children with pediatric B-acute lymphoblastic leukemia.
作者信息
Sharma Nikita, Gupta Richa, Kotru Mrinalini, Gomber Sunil, Gautam Harsh Vardhan
机构信息
Department of Pathology, University College of Medical Sciences Delhi 110095, India.
Department of Pediatrics, University College of Medical Sciences Delhi 110095, India.
出版信息
Am J Blood Res. 2023 Feb 15;13(1):53-60. eCollection 2023.
INTRODUCTION
Acute lymphoblastic leukemia (ALL) is the most common malignancy in children. Despite advancements in treatment, a significant proportion of children relapse. Recently, immunotherapy has gained momentum and is becoming popular, especially for relapsed and refractory cases. NK cells are an important part of tumor immunity and are involved in the direct killing of tumor cells. Their role in B-ALL has not been explored. Therefore, this study was conducted to correlate the number of NK cells with standard prognostic parameters in B-ALL.
METHODS
25 subjects with newly diagnosed B-ALL between 0-14 years were recruited for the study from Pediatric OPD or emergency of the hospital. Along with a complete hemogram and peripheral smear examination, immunophenotyping by flow cytometry was done at the time of diagnosis for NK cell enumeration. The number of NK cells was correlated with standard prognostic parameters using the spearman correlation coefficient.
RESULTS
Baseline NK cell percentage demonstrated a significant negative correlation with Prednisone poor day 8 blast response ( value = 0.02, r value = -0.44) and positive MRD ( value = 0.01, r value = -0.49) at day 33. A negative correlation was also noticed between NK cell percentage and unfavorable cytogenetics (hypodiploidy), although it was not significant ( value = 0.06, r value = -0.38). The number of NK cells did not correlate with age, gender and WBC count. Therefore, evaluating NK cells at diagnosis may serve as a simple and useful parameter for prognostication and risk stratification.
CONCLUSION
It may be assumed that a higher percentage of NK cells is associated with improved outcomes and probably a better prognosis. NK numbers may serve as an early independent parameter predicting prognosis and survival in children with B-ALL, thus helping to decide individual therapeutic regimens.
引言
急性淋巴细胞白血病（ALL）是儿童中最常见的恶性肿瘤。尽管治疗取得了进展，但仍有相当比例的儿童复发。近年来，免疫疗法发展迅速且越来越受欢迎，尤其是对于复发和难治性病例。自然杀伤（NK）细胞是肿瘤免疫的重要组成部分，参与直接杀伤肿瘤细胞。它们在B-ALL中的作用尚未得到探索。因此，本研究旨在探讨B-ALL中NK细胞数量与标准预后参数之间的相关性。
方法
从医院儿科门诊或急诊招募了25名年龄在0至14岁之间新诊断为B-ALL的受试者。除了进行全血细胞计数和外周血涂片检查外，在诊断时通过流式细胞术进行免疫表型分析以计数NK细胞。使用斯皮尔曼相关系数将NK细胞数量与标准预后参数进行相关性分析。
结果
基线NK细胞百分比与第8天泼尼松反应不良时的原始细胞（p值=0.02，r值=-0.44）以及第33天时的阳性微小残留病（p值=0.01，r值=-0.49）呈显著负相关。NK细胞百分比与不良细胞遗传学（亚二倍体）之间也存在负相关，尽管不显著（p值=0.06，r值=-0.38）。NK细胞数量与年龄、性别和白细胞计数无关。因此，在诊断时评估NK细胞可能是一个简单而有用的预后和风险分层参数。
结论
可以假设较高百分比的NK细胞与更好的结局以及可能更好的预后相关。NK细胞数量可能作为预测B-ALL儿童预后和生存的早期独立参数，从而有助于确定个体化治疗方案。
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