慢性淋巴细胞白血病患者免疫化疗阶段b淋巴细胞免疫表型标记分子的表达谱

O. Selyutina, N. Guskova, I. Lysenko, M. A. Konovalchik
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引用次数: 0

摘要

研究目的:目的研究慢性淋巴细胞白血病患者免疫化疗阶段b淋巴细胞免疫表型标记分子的表达,同时监测微小残留病变。患者和方法。20名CLL患者在2019-2022年期间在顿河畔罗斯托夫国家肿瘤医学研究中心接受了6个疗程的RB/FCR模式免疫化疗(ICT)。ICT治疗前、治疗后3、6个疗程均采用流式细胞术进行骨髓免疫分型。数据在Statistica 13.0.Results中进行评估。治疗前,根据预后标志物(CD38、ZAP‑70、CD11c、CD25、FMC7)的表达情况确定3组患者。I(2人)-肿瘤b淋巴细胞不表达CD38、ZAP‑70、CD11c、CD25、FMC7。II(14人)- CD25、CD38表达可变(分别为0.4 - 47.6%和0.0 - 57.5%),缺乏ZAP - 70、CD11c、FMC7的表达。III(4人)-高表达CD38 (57.5 - 69.2%), ZAP‑70 (36.6 - 48.3%),CD11c (20.0 - 96.5%), CD25 (64.9 - 92.7%), FMC7(13.6 - 88.6%)。ICT第3个疗程后,最小残留病(MRD): I组为0%,II组为0.48±0.13%,III组为33.5±7.84%。ICT第6个疗程后MRD: I组为0%,II组为0.42±0.09%,III组为33.2%±8.07%。在ICT治疗3,6个疗程后,II组和III组免疫表型标记物的表达保持不变。根据治疗反应评估标准(IWCLL, 2018),第6个疗程后,I、II组患者完全缓解,III组3例部分缓解,1例过程稳定。初步数据表明,治疗前CLL患者b淋巴细胞上CD38、CD25、ZAP‑70、CD11c、FMC7表达的缺失或升高可能预先决定了RB/FCR方案治疗的血液学反应。最初,所有预后抗原(CD38、CD25、ZAP‑70、CD11c、FMC7)在CLL患者b淋巴细胞肿瘤群体中的同时表达增加与治疗反应不理想相关,从研究所分析的标记分子在免疫化疗阶段实现血液学反应的作用的角度来看,这似乎是有希望的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Expression profile of immunophenotypic marker molecules on B-lymphocytes in patients with chronic lymphocytic leukemia at the stages of immunochemotherapy
Purpose of the study. To study the expression of immunophenotypic marker molecules on B-lymphocytes of patients with chronic lymphocytic leukemia at the stages of immunochemotherapy while monitoring minimal residual disease.Patients and methods. 20 patients with CLL were examined, who in the period 2019–2022 underwent 6 courses of immunochemotherapy (ICT) in the RB/FCR mode at the National Medical Research Centre for Oncology, Rostov-on-Don. Before, after 3, 6 courses of ICT, bone marrow immunophenotyping was performed by flow cytometry. The data is evaluated in Statistica 13.0.Results. Before treatment, 3 groups of patients were identified depending on the expression of prognostic markers (CD38, ZAP‑70, CD11c, CD25, FMC7). I (2 people) – without expression of CD38, ZAP‑70, CD11c, CD25, FMC7 on tumor B-lymphocytes. II (14 people) – with variable expression of CD25, CD38 (0.4–47.6 % and 0.0–57.5 %, respectively), lack of expression of ZAP‑70, CD11c, FMC7. III (4 people)– with high expression of CD38 (57.5–69.2 %), ZAP‑70 (36.6–48.3 %), CD11c (20.0–96.5 %), CD25 (64.9–92.7 %), FMC7 (13.6–88.6 %). After the 3rd course of ICT, the minimum residual disease (MRD): 0 % in group I, 0.48 ±  0.13 % in group II, 33.5 ± 7.84 % in group III. After the 6th course of ICT MRD: 0 % in group I, 0.42 ± 0.09 % in group II, 33.2 ± 8.07 % in group III. The expression of immunophenotypic markers in groups II and III remained unchanged after 3, 6 courses of ICT. According to the criteria for assessing the response to therapy (IWCLL, 2018), patients of groups I, II after the 6th course of ICT have complete remission, 3 patients of group III have partial remission, 1 patient has stabilization of the process. Preliminary data have been obtained indicating that the absence or increased expression of CD38, CD25, ZAP‑70, CD11c, FMC7 on B-lymphocytes of CLL patients before treatment may predetermine the hematological response to therapy according to RB/FCR regimens.Conclusion. Initially, increased expression of all prognostic antigens simultaneously: CD38, CD25, ZAP‑70, CD11c, FMC7 on the tumor population of B-lymphocytes in patients with CLL is associated with an unsatisfactory response to treatment, which seems promising from the point of view of studying the effect of the analyzed marker molecules on achieving a hematological response at the stages of immunochemotherapy.
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