T淋巴细胞亚群异常与淋巴瘤自体造血干细胞移植预后转归的相关性研究
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摘要
目的 :探讨淋巴瘤患者T淋巴细胞亚群异常对自体造血干细胞移植预后的影响。方法 :收集2016年1月—2017年12月接受自体造血干细胞移植的55例淋巴瘤患者的临床资料,回顾性分析T淋巴细胞亚群异常与自体造血干细胞移植转归的相关性,评价T淋巴细胞亚群异常对患者预后的影响。结果 :淋巴瘤患者的年龄与CD3+细胞百分率升高、CD3+CD16+CD56+细胞百分率升高以及CD19+细胞百分率降低均具有相关性(P值均<0.05),而男性与CD3+CD4+细胞百分率升高和CD3-CD16+CD56+细胞百分率降低具有相关性(P值均<0.05)。T淋巴细胞亚群异常与自体造血干细胞移植前完全缓解状态无相关性(P> 0.05)。复发难治性淋巴瘤和CD3-CD16+CD56+细胞百分率降低是移植后淋巴瘤复发进展的危险因素(P值均<0.05)。根据危险因素的个数进行分层,具有0、1和2个危险因素的患者在移植后出现复发进展的比例分别为10.0%、32.3%和100.0%,差异具有统计学意义(P=0.001)。结论 :T淋巴细胞亚群异常可能是影响淋巴瘤患者自体造血干细胞移植预后的不良因素。
Objective: To analyze the effect of abnormal T cell subsets on the prognosis of patients with lymphoma after autologous hematopoietic stem cell transplantation(AHSCT).Methods: The clinical data of 55 patients with lymphoma who received AHSCT from January 2016 to December 2017 were collected. The correlation of abnormal T cell subsets with the outcome of AHSCT was analyzed retrospectively, and the effect of abnormal T cell subsets on the prognosis of patients after AHSCT was evaluated.Results: The age of lymphoma patients was correlated with the increased percentages of CD3+ cells and CD3+CD16+CD56+ cells and the decreased percentage of CD19+ cells(all P < 0.05), while the increased percentages of CD3+CD4+ cells and CD3-CD16+CD56+ cells were found in the male patients with lymphoma(both P < 0.05). Abnormity of T cell subsets was not correlated with the complete remission before AHSCT(P > 0.05). Relapsed/refractory lymphomas and the decreased percentage of CD3-CD16+CD56+ cells were identified as independent risk factors for the progression/relapse of tumor after AHSCT(both P < 0.05). Based on the stratification by these two factors, the incidence of progression/relapse after AHSCT was 10.0%, 32.3% or 100.0% in the patients without risk factor, with 1 or 2 risk factors, respectively(P = 0.001).Conclusion: The abnormal T cell subsets may be a poor prognostic factor for the patients with lymphoma received AHSCT.
Objective: To analyze the effect of abnormal T cell subsets on the prognosis of patients with lymphoma after autologous hematopoietic stem cell transplantation(AHSCT).Methods: The clinical data of 55 patients with lymphoma who received AHSCT from January 2016 to December 2017 were collected. The correlation of abnormal T cell subsets with the outcome of AHSCT was analyzed retrospectively, and the effect of abnormal T cell subsets on the prognosis of patients after AHSCT was evaluated.Results: The age of lymphoma patients was correlated with the increased percentages of CD3+ cells and CD3+CD16+CD56+ cells and the decreased percentage of CD19+ cells(all P < 0.05), while the increased percentages of CD3+CD4+ cells and CD3-CD16+CD56+ cells were found in the male patients with lymphoma(both P < 0.05). Abnormity of T cell subsets was not correlated with the complete remission before AHSCT(P > 0.05). Relapsed/refractory lymphomas and the decreased percentage of CD3-CD16+CD56+ cells were identified as independent risk factors for the progression/relapse of tumor after AHSCT(both P < 0.05). Based on the stratification by these two factors, the incidence of progression/relapse after AHSCT was 10.0%, 32.3% or 100.0% in the patients without risk factor, with 1 or 2 risk factors, respectively(P = 0.001).Conclusion: The abnormal T cell subsets may be a poor prognostic factor for the patients with lymphoma received AHSCT.
引文
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[10]吴梦,王小沛,刘卫平,等.大剂量化疗联合自体造血千细胞移植治疗外周T细瘤巴胞淋的回顾性研究[J].肿瘤,2014,34(11):1028-1 034.
[11] GALVEZ-SILVA J,MAHER OM,PARK M,et al. Prognostic analysis of absolute lymphocyte and monocyte counts after autologous stem cell transplantation in children, adolescents, and young adults with refractory or relapsed hodgkin lymphoma[J]. Biol Blood Marrow Transplant, 2017,23(8):1276-1281.
[12] CHAN FC, MOTTOK A, GERRIE AS, et al.Prognostic model to predict postautologous stem-cell transplantation outcomes in classical hodgkin lymphoma[J]. J Clin Oncol, 2017,35(32):3722-3733.
[13] DAVISON K, CHEN BE, KUKRETI V,et al. Treatment outcomes for older patients with relapsed/refractory aggressive lymphoma receiving salvage chemotherapy and autologous stem cell transplantation are similar to younger patients:A subgroup analysis from the phase III CCTG LY.12 trial[J].Ann Oncol, 201 7, 28(3):622-627.
[14] WU M, WANG X, XIE Y, et al. Outcomeand prospective factor analysis of high-dose therapy combined with autologous peripheral blood stem cell transplantation in patients with peripheral T-cell lymphomas[J]. Int J Med Sci, 2018, 1 5(9):867-874.
[15] GERRIE AS, POWER MM, SHEPHERD JD,et al. Chemoresistance can be overcome with high-dose chemotherapy and autologous stem-cell transplantation for relapsed and refractory Hodgkin lymphoma[J]. Ann Oncol, 2014,25(11):2218-2223.
[16] HE L, ZHU HY, QIN SC, et al. Low natural killer(NK)cell counts in peripheral blood adversely affect clinical outcome of patients with follicular lymphoma[J]. Blood Cancer J,2016, 6(8):e457.
[17] KIM JK, CHUNG JS, SHIN HJ, et al.Influence of NK cell count on the survival of patients with diffuse large B-cell lymphoma treated with R-CHOP[J]. Blood Res, 2014,49(3):162-169.
[18] HUTTUNEN P, TASKINEN M, SIITONEN S,et al. Impact of very early CD4(+)/CD8(+)T cell counts on the occurrence of acute graft-versus-host disease and NK cell counts on outcome after pediatric allogeneic hematopoietic stem cell transplantation[J].Pediatr Blood Cancer, 201 5, 62(3):522-528.
[19] KIM SY, LEE H, HAN MS, et al. Posttransplantation natural killer cell count:A predictor of acute graft-versushost disease and survival outcomes after allogeneic hematopoietic stem cell trans plantation[J]. Clin Lymphoma Myeloma Leuk, 2016, 1 6(9):527-535.
[2] CHEN YB, LANE AA, LOQAN B, et al.Impact of conditioning regimen on outcomes for patients with lymphoma undergoing high-dose therapy with autologous hematopoietic celltransplantation[J]. Biol Blood Marrow Transplant, 201 5, 21(6):1046-1053.
[3] JUDD J, DULAIMI E, LI T, et al. Low level of blood CD4+T cells is an independent predictor of inferior progression-free survival in diffuse large B-cell lymphoma[J]. Clin Lymphoma Myeloma Leuk, 2017,17(2):83-88.
[4] JO JC, KANG BW, JANG G, et al. BEAC or BEAM high-dose chemotherapy followed by autologous stem cell transplantation in non-Hodgkin's lymphoma patients:comparative analysis of efficacy and toxicity[J]. Ann Hematol, 2008, 87(1):43-48.
[5] CHESON BD, FISHER RI, BARRINGTON SF,et al. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and nonHodgkin lymphoma:the Lugano classification[J].J Clin Oncol, 2014,32(2 7):3059-3068.
[6] YIN J, WEI J, XU JH, et al. Autologous stem cell transplantation as the first-line treatment for peripheral T cell lymphoma:Results of a comprehensive meta-analysis[J]. Acta Haematol, 2014, 1 31(2):1 14-125.
[7] WILLIAM BM, LOBERIZA FR JR,WHALEN V,et al. Impact of conditioning regimen on outcome of 2-year diseasefree survivors of autologous stem cell transplantation for Hodgkin lymphoma[J]. Clin Lymphoma Myeloma Leuk, 2013, 1 3(4):41 7-423.
[8] KOLSTAD A, PEDERSEN LB, ESKELUND CW,et al. Molecular monitoring after autologous stem cell transplantation and preemptive rituximab treatment of molecular relapse:Results from thenordic mantle cell lymphoma studies(MCL2 and MCL3)with median followup of 8.5 years[J]. Biol Blood Marrow Transplant, 2017, 23(3):428-435.
[9] YING Z, MI L, WANG X, et al. Prognostic value of pre-and post-transplantation18F-fluorodeoxyglucose positron emission tomography results in non-Hodgkin lymphoma patients receiving autologous stem cell transplantation[J]. Chin J Cancer Res,2017, 29(6):561-571.
[10]吴梦,王小沛,刘卫平,等.大剂量化疗联合自体造血千细胞移植治疗外周T细瘤巴胞淋的回顾性研究[J].肿瘤,2014,34(11):1028-1 034.
[11] GALVEZ-SILVA J,MAHER OM,PARK M,et al. Prognostic analysis of absolute lymphocyte and monocyte counts after autologous stem cell transplantation in children, adolescents, and young adults with refractory or relapsed hodgkin lymphoma[J]. Biol Blood Marrow Transplant, 2017,23(8):1276-1281.
[12] CHAN FC, MOTTOK A, GERRIE AS, et al.Prognostic model to predict postautologous stem-cell transplantation outcomes in classical hodgkin lymphoma[J]. J Clin Oncol, 2017,35(32):3722-3733.
[13] DAVISON K, CHEN BE, KUKRETI V,et al. Treatment outcomes for older patients with relapsed/refractory aggressive lymphoma receiving salvage chemotherapy and autologous stem cell transplantation are similar to younger patients:A subgroup analysis from the phase III CCTG LY.12 trial[J].Ann Oncol, 201 7, 28(3):622-627.
[14] WU M, WANG X, XIE Y, et al. Outcomeand prospective factor analysis of high-dose therapy combined with autologous peripheral blood stem cell transplantation in patients with peripheral T-cell lymphomas[J]. Int J Med Sci, 2018, 1 5(9):867-874.
[15] GERRIE AS, POWER MM, SHEPHERD JD,et al. Chemoresistance can be overcome with high-dose chemotherapy and autologous stem-cell transplantation for relapsed and refractory Hodgkin lymphoma[J]. Ann Oncol, 2014,25(11):2218-2223.
[16] HE L, ZHU HY, QIN SC, et al. Low natural killer(NK)cell counts in peripheral blood adversely affect clinical outcome of patients with follicular lymphoma[J]. Blood Cancer J,2016, 6(8):e457.
[17] KIM JK, CHUNG JS, SHIN HJ, et al.Influence of NK cell count on the survival of patients with diffuse large B-cell lymphoma treated with R-CHOP[J]. Blood Res, 2014,49(3):162-169.
[18] HUTTUNEN P, TASKINEN M, SIITONEN S,et al. Impact of very early CD4(+)/CD8(+)T cell counts on the occurrence of acute graft-versus-host disease and NK cell counts on outcome after pediatric allogeneic hematopoietic stem cell transplantation[J].Pediatr Blood Cancer, 201 5, 62(3):522-528.
[19] KIM SY, LEE H, HAN MS, et al. Posttransplantation natural killer cell count:A predictor of acute graft-versushost disease and survival outcomes after allogeneic hematopoietic stem cell trans plantation[J]. Clin Lymphoma Myeloma Leuk, 2016, 1 6(9):527-535.