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初治弥漫大B细胞淋巴瘤患者化疗后T淋巴细胞亚群变化 |
江志红1,2, 江雅婷1,2, 王晓娜1,2, 张钰鑫1,2, 王扬扬1,2, 魏征3, 邹善华1,2,3
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1.复旦大学附属中山医院厦门医院血液科, 厦门 361015;2.厦门市恶性肿瘤综合治疗临床研究中心, 厦门 361015;3.复旦大学附属中山医院血液科, 上海 200032
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摘要: |
目的 探讨弥漫大B细胞淋巴瘤患者的细胞免疫状态改变及其预测预后的意义。方法 回顾性分析复旦大学附属中山医院厦门医院血液科2018年2月至2020年12月收治的28例初治弥漫大B细胞淋巴瘤患者。用流式细胞仪检测患者化疗前后不同时期外周血T淋巴细胞亚群变化。结果 与化疗前相比,患者化疗后外周血CD4+T淋巴细胞计数及CD4+/CD8+比值均降低。CD4+T淋巴细胞计数在化疗4个周期及6个周期后显著低于化疗前(P<0.05),在化疗4个周期后达最低值[(0.245±0.086)×109/L]。CD4+/CD8+比值在化疗4个周期后、化疗6个周期后、化疗结束后3个月及化疗结束后6个月显著低于化疗前(P<0.05)。终末疗效为完全缓解的患者化疗6个周期后CD4+T淋巴细胞计数及CD4+/CD8+比值高于非完全缓解患者(P<0.05)。复发患者化疗6个周期后CD4+T淋巴细胞计数低于未复发患者(P=0.030)。结论 弥漫大B细胞淋巴瘤患者化疗后存在细胞免疫受损,主要表现为CD4+T淋巴细胞计数在治疗后6个月内先降低后恢复,其化疗早期降低程度可能与患者预后有关。 |
关键词: 弥漫大B细胞淋巴瘤 T淋巴细胞亚群 CD4+T淋巴细胞 CD4+/CD8+比值 |
DOI:10.12025/j.issn.1008-6358.2023.20230226 |
分类号:R733 |
基金项目:上海申康医院发展中心临床研究项目(SHDC2020CR6005). |
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Changes of T lymphocyte subgroups after chemotherapy in patients with newly diagnosed diffuse large B-cell lymphoma |
JIANG Zhi-hong1,2, JIANG Ya-ting1,2, WANG Xiao-na1,2, ZHANG Yu-xin1,2, WANG Yang-yang1,2, WEI Zheng3, ZOU Shan-hua1,2,3
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1.Department of Hematology, Zhongshan Hospital, Fudan University (Xiamen Branch), Xiamen 361015, Fujian, China;2.Xiamen Clinical Research Center for Cancer Therapy, Xiamen 361015, Fujian, China;3.Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
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Abstract: |
Objective To investigate the change of cellular immunity and its prognostic significance in patients with diffuse large B-cell lymphoma. Methods The clinical data of 28 patients with newly diagnosed diffuse large B-cell lymphoma in the Department of Hematology, Xiamen Branch, Zhongshan Hospital, Fudan University from February 2018 to December 2020 were retrospectively analyzed. T lymphocyte subsets in peripheral blood were detected by flow cytometry at different time after chemotherapy. Results The absolute number of CD4+T lymphocytes and the CD4+/CD8+ ratio in peripheral blood of the patients decreased after chemotherapy. The absolute numbers of CD4+T lymphocytes were significantly lower after the fourth and sixth cycle chemotherapy than before chemotherapy (P<0.05), and reached the lowest value ([0.245±0.086]×109/L) after the fourth cycle chemotherapy. The CD4+/CD8+ ratios were significantly lower after the fourth and sixth cycle chemotherapy, at 3 months and 6 months after the end of chemotherapy than before chemotherapy (P<0.05). The absolute number of CD4+T lymphocyte and the CD4+/CD8+ ratio after sixth cycle chemotherapy in the complete response group were higher than those in the incomplete response group (P<0.05). The absolute number of CD4+T lymphocyte after the sixth cycle chemotherapy in the recurrent group was lower than that in the non-recurrent group (P=0.030). Conclusions The cellular immunity of patients with diffuse large B cell lymphoma is impaired after chemotherapy. The main manifestation is that the CD4+T lymphocyte count decreases first and then increases within 6 months after treatment and the severity of the CD4+T lymphocyte decrease in the early stage after chemotherapy is related to prognosis of the patients. |
Key words: diffuse large B-cell lymphoma T lymphocyte subgroups CD4+T lymphocyte CD4+/CD8+ratio |