不适合移植的大 B 细胞淋巴瘤二线使用 axicabtagene ciloleucel:ALYCANTE 最终分析
Second-line axicabtagene ciloleucel in large B-cell lymphoma ineligible for transplantation: ALYCANTE final analysis.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:The Characteristics of Peripheral Blood Lymphocyte Subsets in HIV-related Diffuse Large B-cell Lymphoma Patients and Their Impact on Treatment Efficacy.
The Characteristics of Peripheral Blood Lymphocyte Subsets in HIV-related Diffuse Large B-cell Lymphoma Patients and Their Impact on Treatment Efficacy.
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本研究揭示了 HIV-DLBCL 患者中一种独特的免疫失调模式,以 CD4 T 细胞耗竭和 CD8 T 细胞扩增为特征,这与既往研究一致。
研究纳入51例HIV-DLBCL患者、50例DLBCL患者和42名健康供者(HD)。数据取自门诊病历和医院信息管理系统,并使用SPSS 27.0进行统计分析。
各组淋巴细胞亚群存在显著差异。与DLBCL患者和健康供者相比,HIV-DLBCL患者CD4 T细胞和调节性T细胞(Treg)的计数及比例降低,而CD8 T细胞计数和比例以及Treg比例升高。按年龄分层分析显示,与较年轻患者相比,老年HIV-DLBCL患者的CD8 T细胞计数较低、CD3 T细胞比例降低,而CD56+CD16+ NK细胞比例升高。 讨论:本研究发现HIV-DLBCL患者具有独特的免疫失调模式,表现为CD4 T细胞减少和CD8 T细胞扩增,这与既往研究一致。年龄相关的免疫衰老可能加剧NK细胞比例升高及T细胞功能下降,提示老年患者预后可能较差。不过,淋巴细胞亚群与化疗疗效之间未见关联,这可能反映标准治疗方案广泛影响免疫重建。研究局限包括样本量小、缺乏功能实验,以及未评估合并感染的影响。未来研究应扩大队列并整合多组学数据以验证这些发现。
与DLBCL患者相比,HIV-DLBCL患者外周血淋巴细胞亚群存在特征性改变,例如CD4+ T细胞绝对计数和比例下降。这些变化似与年龄相关,且与既往抗逆转录病毒治疗无显著关联。然而,对于HIV-DLBCL,化疗疗效可能不受外周血CD4+ T细胞绝对计数及比例偏低、或患者既往是否接受抗逆转录病毒治疗的影响。
Overall, 51 HIV-DLBCL patients, 50 DLBCL patients, and 42 Healthy Donors (HD) were enrolled in the study. Data were extracted from outpatient records and the Hospital Information Management System. SPSS 27.0 software was used for statistical analysis of the data.
Significant differences in lymphocyte subsets were observed between groups. HIVDLBCL patients showed decreased CD4 T cell and regulatory T cell (Treg) counts/percentages compared to DLBCL patients and HD, but increased CD8 T cell counts and percentages, as well as Treg percentages. Age-stratified analysis revealed that older HIV-DLBCL patients had lower CD8 T cell counts, reduced CD3 T cell percentages, and elevated CD56 CD16 NK cell proportions compared to their younger counterparts. DISCUSSION: This study revealed a distinct pattern of immune dysregulation in HIV-DLBCL patients, characterized by CD4 T cell depletion and CD8 T cell expansion, which is consistent with previous studies. Age-related immunosenescence may exacerbate the increased proportion of NK cells and the decline in T-cell function, suggesting a poorer prognosis in elderly patients. However, the lack of association between lymphocyte subsets and chemotherapy efficacy may reflect the broad impact of standard regimens on immune reconstitution. Limitations include the small sample size, absence of functional experiments, and failure to assess the influence of coinfections. Future studies should expand the cohort and integrate multi-omics data to validate these findings.
Patients with HIV-DLBCL have distinctive alterations in peripheral blood lymphocyte subsets, such as a decreased absolute count and percentage of CD4+ T cells, in comparison to individuals with DLBCL. These alterations appear age-related and showed no significant association with prior antiretroviral therapy. The therapeutic effect of chemotherapy for HIV-DLBCL, however, might not be impacted by the low absolute count and percentage of CD4+ T-cells in peripheral blood, as well as whether or not they had previously received antiretroviral therapy.these findings.
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