中国输血杂志2025，Vol.38Issue(7)：902-908,7.DOI:10.13303/j.cjbt.issn.1004-549x.2025.07.006
急性髓系白血病骨髓淋巴细胞亚群的表达及对预后的影响
Expression of lymphocyte subsets in the bone marrow of patients with acute myeloid leukemia and its influence on prognosis
摘要
Abstract
Objective To explore the correlation between the composition of bone marrow lymphocyte subsets and the clinical attributes observed in de novo AML patients,as well as their influence on prognosis.Methods A detailed study was carried out on a cohort of 191 de novo acute myeloid leukemia patients who were admitted to our medical center between October 2022 and September 2024.In addition,a group of 24 patients with iron deficiency anemia individuals was carefully chosen as the control cohort.The proportions of lymphocyte subsets within the bone marrow of de novo AML patients were analyzed.Furthermore,an in-depth analysis was performed to investigate the association between the expression levels of these subsets in de novo AML patients and their clinical attributes,as well as their prognostic implications.Results The proportion of CD19+and CD56+lymphocytes within the bone marrow of de novo AML patients significantly diminished com-pared to the control cohort(8.5%vs 13.2%P<0.05,and 15.5%vs 18.0%,P<0.05).Conversely,no significant discrep-ancies were observed in the CD3+,CD3+CD4+,and CD3+CD8+lymphocyte percentages between the AML patients and con-trol group(71.7%vs 72.1%,32.5%vs 33.7%and 32.8%vs 35.7%,P>0.05).When analyzing the relationships be-tween lymphocyte subsets within the bone marrow of de novo patients and their respective clinical characteristics,patients aged 60 years and above exhibited diminished percentages of CD3+CD8+lymphocytes in the bone marrow compared to their younger counterparts(31.6%vs 34.1%,P<0.05),while the CD56+lymphocyte subsets demonstrated an increased preva-lence(17.2%vs 14.4%,P<0.05).Furthermore,patients with leukocytosis(WBC≥100×109/L)presented lower levels of CD3+and CD3+CD4+lymphocytes in the bone marrow compared with those without it(65.3%vs 72.9%P<0.05,and 28.9%vs 33.2%,P<0.05),respectively.The AML1-ETO fusion gene-positive cohort exhibited a higher prevalence of CD3+CD8+lymphocytes in the bone marrow than in the negative group(38.2%vs 32.3%,P<0.05),whereas the FLT3-ITD mutation-positive group presented a decreased prevalence of CD56+lymphocytes compared with the negative group(12.4%vs 16.8%,P<0.05).In addition,the NPM1 mutation-positive group demonstrated lower levels of CD3+CD8+lymphocytes in the bone marrow than in the negative group(29.1%vs 33.3%,P<0.05).Variables such as tumor protein p53(TP53)mutation positive,the absence of hematopoietic stem cell transplantation,and CD3+CD4+lymphocyte propor-tions below 25%were identified as independent adverse prognostic indicators for AML patients(P<0.05).Conclusion The pathogenesis of AML is closely associated with an imbalance in bone marrow lymphocyte subsets.The FLT3-ITD muta-tion potentially contributes to the dysregulation of CD56+lymphocyte subset expression.The AML1-ETO fusion gene and NPM1 mutation are implicated in the abnormal expression of CD3+CD8+lymphocytes within the bone marrow.Moreover,the percentage of CD3+CD4+lymphocytes in the bone marrow serves as a prognostic factor for de novo AML patients.关键词
急性髓系白血病/淋巴细胞亚群/骨髓微环境/预后因素Key words
acute myeloid leukemia/lymphocyte subsets/bone marrow microenvironment/prognosis factor分类
医药卫生引用本文复制引用
聂金红,肖介兵,邵迎春,李城卉,高庐,马骁,吴小津,朱子玲..急性髓系白血病骨髓淋巴细胞亚群的表达及对预后的影响[J].中国输血杂志,2025,38(7):902-908,7.基金项目
国家自然科学基金(82170222) （82170222）
苏州市重点疾病项目(LCZX202101) （LCZX202101）
江苏省血液病医学创新中心(CXZX202201) （CXZX202201）
