Calik Sebnem, Bilgir Oktay, Demir İsmail, Tosun Selma, Özdemir Yeliz
Infectious Diseases and Clinical Microbiology Clinic, University of Health Science Izmir Bozyaka Training and Research Hospital, Izmir, Turkey.
Hematology Clinic, University of Health Science Izmir Bozyaka Training and Research Hospital, Izmir, Turkey.
J Int Med Res. 2025 Mar;53(3):3000605241276482. doi: 10.1177/03000605241276482. Epub 2025 Mar 12.
ObjectivesAcute leukemia often leads to severe complications such as febrile neutropenia. Mortality rates remain high, underscoring the need for novel prognostic markers. Regulatory T cells (Tregs) have not been extensively studied in this context.MethodsThis prospective observational, single-center study included 114 patients diagnosed with acute leukemia. Tregs percentages were measured using flow cytometry. Statistical analyses involved logistic regression to identify factors significantly associated with survival.ResultsOf the 114 patients, 78 recovered, while 36 died. The median Treg percentages were 5.9% in patients under 65 years and 5.38% in those 65 and older. A lower percentage of Tregs was associated with higher mortality in the older group (p = 0.04). Multivariate analysis highlighted the presence of comorbidities, documented infections, and day seven C-reactive protein levels as significant predictors of survival.ConclusionThis study supports the importance of monitoring chronic diseases and infection foci alongside traditional markers like C-reactive protein. Future research should explore the mechanistic roles of Tregs in immunosuppression and survival in this vulnerable population.
目的
急性白血病常导致严重并发症，如发热性中性粒细胞减少。死亡率仍然很高，这凸显了对新型预后标志物的需求。调节性T细胞（Tregs）在这方面尚未得到广泛研究。
方法
这项前瞻性观察性单中心研究纳入了114例诊断为急性白血病的患者。使用流式细胞术测量Tregs百分比。统计分析采用逻辑回归来确定与生存显著相关的因素。
结果
114例患者中，78例康复，36例死亡。65岁以下患者的Tregs百分比中位数为5.9%，65岁及以上患者为5.38%。老年组中较低的Tregs百分比与较高的死亡率相关（p = 0.04）。多变量分析强调合并症、有记录的感染以及第7天的C反应蛋白水平是生存的重要预测指标。
结论
本研究支持在监测传统标志物如C反应蛋白的同时，监测慢性疾病和感染灶的重要性。未来的研究应探索Tregs在这一脆弱人群的免疫抑制和生存中的机制作用。
