Liu Yanfei, Song Weiwei, Song Yuqin, Zhu Jun, Xie Yan
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital & Institute, Fucheng Road 52, Haidian Region, Beijing, 100142, China.
Ann Hematol. 2025 Mar;104(3):1705-1712. doi: 10.1007/s00277-025-06314-0. Epub 2025 Mar 26.
To investigate the prognostic significance of lymphocyte subsets in newly diagnosed angioimmunoblastic T-cell lymphoma (AITL) patients and track the dynamic changes in these subsets during treatment. We retrospectively analyzed the medical records in 56 patients with AITL. Lymphocyte subsets were assessed by flow cytometry at diagnosis. Receiver operating characteristic curves were employed to establish optimal cut-off values for lymphocyte subset assessment. Univariate and multivariate analyses were used to evaluate overall survival (OS) and progression-free survival (PFS). The first-line treatment demonstrated an overall response rate (ORR) of 71.4%. Optimal cut-off values for ORR were determined for CD3 + T cell percentage (61.9%) and CD8 + T cell percentage (28.4%), with corresponding AUC of 0.756 [95% CI (0.611-0.902), p = 0.003] and 0.745 [95% CI (0.596-0.894), p = 0.004]. The ORR for the Low CD3+/CD8 + Group (CD3 + T < 61.9% and CD8 + T < 28.4%) and High CD3+/CD8 + Group (CD3 + T ≥ 61.9% or CD8 + T ≥ 28.4%) was 25.0% and 84.1%, respectively (p < 0.001). With a median follow-up time of 37.4 months, the median PFS were 5.6 and 16.0 months for the both groups. After two cycles of chemotherapy, a significant elevation in the percentage of CD3 + T cells was observed comparing to pre-treatment. Three months post-treatment, the CD4/CD8 ratio reduced significantly, indicating a rebalancing of T cell populations. Reduced levels of CD3 + and CD8 + T lymphocyte may indicate inferior chemotherapy efficacy and poorer PFS in AITL. Monitoring the baseline lymphocyte subsets and their dynamic changes can assist in clinical treatment decision - making.
为了研究新诊断的血管免疫母细胞性T细胞淋巴瘤（AITL）患者淋巴细胞亚群的预后意义，并追踪这些亚群在治疗期间的动态变化。我们回顾性分析了56例AITL患者的病历。在诊断时通过流式细胞术评估淋巴细胞亚群。采用受试者工作特征曲线来确定淋巴细胞亚群评估的最佳临界值。单因素和多因素分析用于评估总生存期（OS）和无进展生存期（PFS）。一线治疗的总缓解率（ORR）为71.4%。确定了CD3 + T细胞百分比（61.9%）和CD8 + T细胞百分比（28.4%）的ORR最佳临界值，相应的曲线下面积（AUC）分别为0.756 [95%置信区间（CI）（0.611 - 0.902），p = 0.003]和0.745 [95% CI（0.596 - 0.894），p = 0.004]。低CD3+/CD8 +组（CD3 + T < 61.9%且CD8 + T < 28.4%）和高CD3+/CD8 +组（CD3 + T ≥ 61.9%或CD8 + T ≥ 28.4%）的ORR分别为25.0%和84.1%（p < 0.001）。中位随访时间为37.4个月，两组的中位PFS分别为5.6个月和16.0个月。化疗两个周期后，与治疗前相比，观察到CD3 + T细胞百分比显著升高。治疗后三个月，CD4/CD8比值显著降低，表明T细胞群体重新平衡。CD3 +和CD8 + T淋巴细胞水平降低可能表明AITL患者化疗疗效较差且PFS较差。监测基线淋巴细胞亚群及其动态变化有助于临床治疗决策。
