Seyithanoglu Deniz, Sert Esra Nazligul, Ozbalak Murat, Mastanzade Metban, Erdem Simge, Yenerel Mustafa N
Department of Internal Medicine, Istanbul University Faculty of Medicine, Istanbul, Turkey.
Department of Hematology, Istanbul University Faculty of Medicine, Istanbul, Turkey.
Acta Haematol. 2025 Mar 17:1-10. doi: 10.1159/000545269.
Changes in the number and functional capacity of T lymphocytes have been reported in chronic lymphocytic leukemia (CLL) patients. The aim of this study was to examine the prognostic significance of T-lymphocyte subgroups in CLL patients.
Eighty-three previously untreated patients were retrospectively enrolled and flow cytometry results at diagnosis were examined. No difference was found in T-lymphocyte parameters according to age, gender, and disease stage.
The CD4 and CD7 percentages, CD4/MBC (malignant B cell), CD8/MBC, and CD7/MBC values at diagnosis were significantly lower in patients with a progressive disease. T-lymphocyte percentages were significantly lower in deceased patients. In the univariate regression model, T-lymphocyte percentages, T-lymphocyte/MBC ratios, HLA-DR+ percentage, Rai stage (intermediate + high risk), Binet stage (B+C), and beta-2 microglobulin level had significant effects on both progression-free survival (PFS) and overall survival (OS); treatment status (yes) had a significant effect only on PFS, while age at diagnosis (≥65 years) had a significant effect only on OS. In the multivariate regression model, Rai stage, CD7/MBC ratio, and treatment status (yes) had a significant effect on PFS; Rai stage and CD8/MBC ratio had a significant effect on OS.
Lower T-lymphocyte/MBC ratios at diagnosis could be a marker for higher risk of CLL progression.
据报道，慢性淋巴细胞白血病（CLL）患者的T淋巴细胞数量和功能能力会发生变化。本研究的目的是探讨CLL患者T淋巴细胞亚群的预后意义。
回顾性纳入83例未经治疗的患者，并检查诊断时的流式细胞术结果。根据年龄、性别和疾病分期，未发现T淋巴细胞参数存在差异。
疾病进展患者诊断时的CD4和CD7百分比、CD4/恶性B细胞（MBC）、CD8/MBC和CD7/MBC值显著较低。死亡患者的T淋巴细胞百分比显著较低。在单变量回归模型中，T淋巴细胞百分比、T淋巴细胞/MBC比值、HLA-DR+百分比、Rai分期（中+高风险）、Binet分期（B+C）和β2微球蛋白水平对无进展生存期（PFS）和总生存期（OS）均有显著影响；治疗状态（是）仅对PFS有显著影响，而诊断时年龄（≥65岁）仅对OS有显著影响。在多变量回归模型中，Rai分期、CD7/MBC比值和治疗状态（是）对PFS有显著影响；Rai分期和CD8/MBC比值对OS有显著影响。
诊断时较低的T淋巴细胞/MBC比值可能是CLL进展风险较高的一个标志物。
