Clinical determination of lymphocyte subsets in peripheral blood of patients with angioimmunoblastic T cell lymphoma

doi:10.3969/j.issn.1004-583X.2022.11.007

Abstract

Abstract:

Objective To analyze the relevance between lymphocyte subsets and clinical prognosis in the peripheral blood of patients with angioimmunoblastic T cell lymphoma (AITL) during diagnosis, and to assess their dynamic changes after chemotherapy.M-ethods The clinical data of 16 initial AITL patients (treatment group) and 10 lymphocyte subsets (control group) were retrospectively analyzed, these patients visited the Third Affiliated Hospital of Soochow University between March 2016 and September 2021. Kaplan-Meier method and Cox regression were adopted for survival analysis. Receiver Operator Characteristic (ROC)curve was used to calculate the cutoff value of CD4/CD8 ratio, and the patients of the treatment group were assigned into low and high CD4/CD8 groups. Results Compared to the controls, the absolute count of CD3⁺T cells, CD4⁺ T cells, CD3⁺CD25⁺ activated T cells and CD4/CD8 ratio significantly decreased in the peripheral blood of AITL patients at the initial diagnosis. Whereas, the absolute count of CD19⁺ B cells, CD20⁺ B cells, CD5⁺CD19⁺ and CD19⁺CD23⁺ activated B cell significantly decreased. The proportion of CD3⁺ T cells after the first course of chemotherapy significantly increased than that at the initial diagnosis, and the proportion of CD4⁺ T cells, CD3⁺CD25⁺ activated T cells and CD4/CD8 significantly increased after three courses of the treatment. The survival analysis showed that the progression-free-survival (PFS) and overall survival (OS) of the low CD4/CD8 group were significantly higher than those of the CD4/CD8 group. Conclusion High CD4/CD8 ratio in peripheral blood at the initial diagnosis of AITL patients is associated with poor prognosis. CD4⁺ T cell count in the peripheral blood of patients is significantly decreased compared with healthy people, and which can be partially recovered after effective treatment. The analysis on lymphocyte subsets in AITL supports providing new ideas for identifying new prognostic markers of AITL and implementing effective individualized immunotherapy.

Key words: lymphoma, T cells, lymphocyte subsets, CD4⁺ T cells, CD4/CD8

CLC Number:

R733.4

Lu Luo, Wang Fei, Gu Weiying. Clinical determination of lymphocyte subsets in peripheral blood of patients with angioimmunoblastic T cell lymphoma[J]. Clinical Focus, 2022, 37(11): 1001-1007.

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URL: http://www.lchc.cn/EN/10.3969/j.issn.1004-583X.2022.11.007

http://www.lchc.cn/EN/Y2022/V37/I11/1001

Figures/Tables 5

临床特征	高CD4/CD8组 ( $n$ =5)	低CD4/CD8组 ( $n$ =11)	$P$ 值
年龄
<60岁 ≥60岁	0 5	4 7	0.245
性别
男女	4 1	6 5	0.588
ECOG评分
0~1分 2~4分	1 4	7 4	0.282
Ann Arbor分期
Ⅰ~Ⅱ期 Ⅲ~Ⅳ期	0 5	1 10	1.000
结外
无有	2 3	5 6	1.000
骨髓受累
无有	4 1	10 1	1.000
浆膜腔积液
无有	1 4	6 5	0.308
B症状
无有	2 3	2 9	0.547
LDH
>250 U/L ≤250 U/L	3 2	7 4	1.000
IPI评分
0~2分 3~5分	1 4	4 7	0.622
PIT评分
0~1分 2~4分	0 5	4 7	0.245
PIAI评分
0~1分 2~5分	1 4	1 10	1.000

临床特征	高CD4/CD8组 ( $n$ =5)	低CD4/CD8组 ( $n$ =11)	$P$ 值
年龄
<60岁 ≥60岁	0 5	4 7	0.245
性别
男女	4 1	6 5	0.588
ECOG评分
0~1分 2~4分	1 4	7 4	0.282
Ann Arbor分期
Ⅰ~Ⅱ期 Ⅲ~Ⅳ期	0 5	1 10	1.000
结外
无有	2 3	5 6	1.000
骨髓受累
无有	4 1	10 1	1.000
浆膜腔积液
无有	1 4	6 5	0.308
B症状
无有	2 3	2 9	0.547
LDH
>250 U/L ≤250 U/L	3 2	7 4	1.000
IPI评分
0~2分 3~5分	1 4	4 7	0.622
PIT评分
0~1分 2~4分	0 5	4 7	0.245
PIAI评分
0~1分 2~5分	1 4	1 10	1.000

影响因素	PFS		OS
影响因素	$H R$ (95% $C I$ )	$P$ 值	$H R$ (95% $C I$ )	$P$ 值
年龄	1.048(0.968-1.134)	0.246	1.086(0.092-1.190)	0.076
Ann Arbor分期	3.784(0.537-26.648)	0.181	3.072(0.443-21.320)	0.256
B症状	0.812(0.168-3.938)	0.796	1.065(0.213-5.330)	0.939
ECOG评分	3.408(1.400-8.296)	0.007	3.331(1.256-8.832)	0.016
IPI评分	1.783(0.862-3.685)	0.119	1.487(0.719-3.074)	0.284
PIT评分	4.897(1.510-15.883)	0.008	2.551(0.954-6.822)	0.062
PIAI评分	3.999(1.514-10.562)	0.005	2.185(1.051-4.545)	0.036
结外受累	0.841(0.224-3.154)	0.797	1.193(0.298-4.786)	0.803
骨髓受累	0.915(0.112-7.454)	0.934	0.755(0.092-6.222)	0.794
浆膜腔积液	0.238(0.049-1.158)	0.075	0.103(0.012-0.850)	0.035
Ki67	0.996(0.953-1.040)	0.843	0.990(0.944-1.038)	0.684
LDH	0.999(0.993-1.005)	0.770	1.000(0.993-1.006)	0.880
β₂微球蛋白	1.379(1.037-1.834)	0.027	1.338(0.976-1.834)	0.071
白蛋白	0.773(0.621-0.961)	0.021	0.811(0.654-1.007)	0.058
白细胞	1.059(0.900-1.247)	0.489	1.051(0.883-1.252)	0.576
Kappa链	1.001(1.000-1.003)	0.050	1.002(1.000-1.003)	0.068
Lambda链	1.001(1.000-1.003)	0.036	1.003(1.000-1.006)	0.026
IgG	1.072(0.994-1.156)	0.071	1.102(1.007-1.205)	0.034
CD4/CD8	0.205(0.053-0.792)	0.022	0.136(0.031-0.596)	0.008

影响因素	PFS		OS
影响因素	$H R$ (95% $C I$ )	$P$ 值	$H R$ (95% $C I$ )	$P$ 值
年龄	1.048(0.968-1.134)	0.246	1.086(0.092-1.190)	0.076
Ann Arbor分期	3.784(0.537-26.648)	0.181	3.072(0.443-21.320)	0.256
B症状	0.812(0.168-3.938)	0.796	1.065(0.213-5.330)	0.939
ECOG评分	3.408(1.400-8.296)	0.007	3.331(1.256-8.832)	0.016
IPI评分	1.783(0.862-3.685)	0.119	1.487(0.719-3.074)	0.284
PIT评分	4.897(1.510-15.883)	0.008	2.551(0.954-6.822)	0.062
PIAI评分	3.999(1.514-10.562)	0.005	2.185(1.051-4.545)	0.036
结外受累	0.841(0.224-3.154)	0.797	1.193(0.298-4.786)	0.803
骨髓受累	0.915(0.112-7.454)	0.934	0.755(0.092-6.222)	0.794
浆膜腔积液	0.238(0.049-1.158)	0.075	0.103(0.012-0.850)	0.035
Ki67	0.996(0.953-1.040)	0.843	0.990(0.944-1.038)	0.684
LDH	0.999(0.993-1.005)	0.770	1.000(0.993-1.006)	0.880
β₂微球蛋白	1.379(1.037-1.834)	0.027	1.338(0.976-1.834)	0.071
白蛋白	0.773(0.621-0.961)	0.021	0.811(0.654-1.007)	0.058
白细胞	1.059(0.900-1.247)	0.489	1.051(0.883-1.252)	0.576
Kappa链	1.001(1.000-1.003)	0.050	1.002(1.000-1.003)	0.068
Lambda链	1.001(1.000-1.003)	0.036	1.003(1.000-1.006)	0.026
IgG	1.072(0.994-1.156)	0.071	1.102(1.007-1.205)	0.034
CD4/CD8	0.205(0.053-0.792)	0.022	0.136(0.031-0.596)	0.008

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