老年急性髓系白血病淋巴细胞亚群分布及预后
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摘要
目的探讨老年急性髓系白血病淋巴细胞亚群分布特点,及对预后影响。方法选取2015年1月—2018年10月在我院救治的老年急性髓系白血病患者80例作为研究对象,回归分析所有患者的临床资料,总结淋巴细胞亚群分布特点及对预后的影响。结果四种分型中淋巴细胞亚群占比比较,差异不具有统计学意义(P> 0.05);影响预后效果的危险因素主要有:FLT3-ITD突变阳性、初次诱导达到CR、年龄、CD3~+、CD4~+、白细胞计数;另外,经过治疗OR组患者CD3~+、CD4~+、CD4~+/CD8~+水平高于NR组,差异具有统计学意义(P <0.05);OR组患者CD8~+略低于NR组,对比差异无统计学意义(P> 0.05)。结论急性髓系白血病老年患者淋巴细胞亚群增高,会抑制患者的免疫功能,所以利用淋巴细胞亚群特点能分析评估出患者的预后效果。
Objective To investigate the distribution of lymphocyte subsets in elderly patients with acute myeloid leukemia and its influence on prognosis. Methods 80 elderly patients with acute myeloid leukemia treated in our hospital from January 2015 to October 2018 were studied. The clinical data of all patients were analyzed retrospectively, and the distribution characteristics of lymphocyte subsets and their influence on prognosis were summarized. Results There was no significant difference in the proportion of lymphocyte subsets among the four types(P > 0.05). The main risk factors affecting the prognosis were FLT3-ITD mutation positive, CR, age, CD3~+, CD4~+, white blood cell count in the first induction. In addition, the levels of CD3~+, CD4~+, CD4~+/CD8~+ in the OR group were higher than those in the NR group, and the difference was statistically significant(P < 0.05). CD8~+ in OR group was slightly lower than that in NR group, with no significant difference(P > 0.05). Conclusion The increase of lymphocyte subsets in elderly patients with acute myeloid leukemia can inhibit the immune function of the patients, so the prognosis of the patients can be evaluated by the characteristics of lymphocyte subsets.
Objective To investigate the distribution of lymphocyte subsets in elderly patients with acute myeloid leukemia and its influence on prognosis. Methods 80 elderly patients with acute myeloid leukemia treated in our hospital from January 2015 to October 2018 were studied. The clinical data of all patients were analyzed retrospectively, and the distribution characteristics of lymphocyte subsets and their influence on prognosis were summarized. Results There was no significant difference in the proportion of lymphocyte subsets among the four types(P > 0.05). The main risk factors affecting the prognosis were FLT3-ITD mutation positive, CR, age, CD3~+, CD4~+, white blood cell count in the first induction. In addition, the levels of CD3~+, CD4~+, CD4~+/CD8~+ in the OR group were higher than those in the NR group, and the difference was statistically significant(P < 0.05). CD8~+ in OR group was slightly lower than that in NR group, with no significant difference(P > 0.05). Conclusion The increase of lymphocyte subsets in elderly patients with acute myeloid leukemia can inhibit the immune function of the patients, so the prognosis of the patients can be evaluated by the characteristics of lymphocyte subsets.
引文
[1]林冬,魏辉,王迎,等.FLT3-ITD突变阳性急性髓系白血病的临床特征和预后因素[J].中华血液学杂志,2016,37(12):1017-1021.
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[8]朱琳,安利,王增胜,等.获得性纯红细胞再生障碍性贫血患者的T淋巴细胞亚群分析及疗效观察[J].国际输血及血液学杂志,2016,39(4):319-324.
[9]张司琪,葛健,夏瑞祥.急性白血病患者外周血T细胞亚群、NK细胞和调节性T细胞的检测及临床意义[J].安徽医科大学学报,2016,51(2):218-221.
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[11]王玮,刘烨,黄垚.血清铁蛋白、T淋巴细胞亚群在急性白血病患者中的水平变化及临床意义[J].医学综述,2016,22(5):983-985.
[12]王西阁,张晓敏,赵雪莲,等.急性淋巴细胞白血病患儿外周血IL-17、IL-35及T淋巴细胞亚群的变化及意义[J].当代医学,2016,22(2):6-8.
[2]汪宏梅,张云宁,罗云.流式细胞学技术检测急性髓细胞白血病患者外周血淋巴细胞亚群的效果分析[J].实用临床医药杂志,2017,21(21):36-38.
[3]郑玉婷,李冰霞,孙玉晶,等.急性髓系白血病患者骨髓中WT1的表达及其对预后的影响[J].中国实验血液学杂志,2016,24(3):649-654.
[4]朱丽丹,张曦,冯一梅,等.依托泊苷联合G-CSF、低剂量阿糖胞苷、阿克拉霉素治疗初诊老年急性髓系白血病的临床研究[J].中国输血杂志,2016,29(10):1099-1101.
[5]金香淑,杨岚,汪变红,等.急性淋巴细胞白血病中枢神经系统白血病21例临床特征与预后分析[J].中国实验血液学杂志,2016,24(6):1675-1682.
[6]董小林,张少君,杨洁.联合检测凋亡抑制蛋白及脑和急性白血病胞质蛋白在老年急性髓系白血病中的意义[J].临床内科杂志,2017,34(8):535-537.
[7]张洁心,吴蕾,戎国栋,等.巨细胞病毒感染对异体造血干细胞移植急性髓系白血病患者外周血CD8+/CD4+T细胞,,,,分布的影响[J].江苏大学学报(医学版),2017,27(5):423-427.
[8]朱琳,安利,王增胜,等.获得性纯红细胞再生障碍性贫血患者的T淋巴细胞亚群分析及疗效观察[J].国际输血及血液学杂志,2016,39(4):319-324.
[9]张司琪,葛健,夏瑞祥.急性白血病患者外周血T细胞亚群、NK细胞和调节性T细胞的检测及临床意义[J].安徽医科大学学报,2016,51(2):218-221.
[10]丁辉.血清铁蛋白与T淋巴细胞亚群在急性白血病患者中的变化及意义[J].中国继续医学教育,2016,8(24):37-38.
[11]王玮,刘烨,黄垚.血清铁蛋白、T淋巴细胞亚群在急性白血病患者中的水平变化及临床意义[J].医学综述,2016,22(5):983-985.
[12]王西阁,张晓敏,赵雪莲,等.急性淋巴细胞白血病患儿外周血IL-17、IL-35及T淋巴细胞亚群的变化及意义[J].当代医学,2016,22(2):6-8.