[The Distribution and Significance of Activated T Cells and Lymphocyte Subsets in Myelodysplastic Syndrome].

OBJECTIVE: To investigate the distribution of bone marrow lymphocyte subsets in patients with myelodysplastic syndrome(MDS),the proportion of activated T cells with immunophenotype CD3+HLA-DR+ in the lymphocytes and its clinical significance, and to understand the effects of different types of MDS, different immunophenotypes, and different expression levels of WT1 on the proportion of lymphocyte subsets and activated T cells. METHODS: The immunophenotypes of 96 MDS patients, the subsets of bone marrow lymphocytes and activated T cells were detected by flow cytometry. The relative expression of WT1 was detected by real-time fluorescent quantitative PCR, and the first induced remission rate (CR1) was calculated, the differences of lymphocyte subsets and activated T cells in MDS patients with different immunophenotype, different WT1 expression, and different course of disease were analyzed. RESULTS: The percentage of CD4+T lymphocyte in MDS-EB-2, IPSS high-risk, CD34+ cells >10%, and patients with CD34+CD7+ cell population and WT1 gene overexpression at intial diagnosis decreased significantly (P<0.05), and the percentage of NK cells and activated T cells increased significantly (P<0.05), but there was no significant difference in the ratio of B lymphocytes. Compared with the normal control group, the percentage of NK cells and activated T cells in IPSS-intermediate-2 group was significantly higher(P<0.05), but there was no significant difference in the percentage of CD3+T, CD4+T lymphocytes. The percentage of CD4+T cells in patients with complete remission after the first chemotherapy was significantly higher than in patients with incomplete remission(P<0.05), and the percentage of NK cells and activated T cells was significantly lower than that in patients with incomplete remission (P<0.05). CONCLUSION: In MDS patients, the proportion of CD3+T and CD4+T lymphocytes decreased, and the proportion of activated T cells increased, indicating that the differentiation type of MDS is more primitive and the prognosis is worse.

[Expression of CD19 and CD56 in AML Patients with RUNX1-RUNX1T1 Mutation and Its Clinical Significance].

OBJECTIVE: To investigate the clinical significance of RUNX1-RUNX1T1 expression level in bone marrow of patients with acute non-M3 myeloid leukemia (AML non-M3), and to understand the biological characteristics of RUNX1-RUNX1T1 positive AML expressing lymphoid antigens CD19, CD56 and its effect on the initially induced remission rate and prognosis. METHODS: The expression level of RUNX1-RUNX1T1 in bone marrow of 200 patients with newly diagnosed AML (non-M3) was detected by real-time fluorescent Q-PCR, the expression level of lymphoid antigens was detected by flow cytometry, and the relationship of the initially induced remission rate (CR1) with the overall survival (OS) rate was analyzed, the CR1 and OS differences also were analyzed between CD56+ and CD56- patients as well as CD19+ and CD17- patients in RUNX1-RUNX1T1 positive patients with AML. RESULTS: The CD56+ patients at the initial diagnosis had lower CR1(P<0.05) in RUNX1-RUNX1T1 positive AML patients, the CR1 of CD19+ patients was higher than that in CD19- patients at the initial diagnosis (P<0.05). The OS of CD56+ patients was significantly high in comparison with CD56- patients (P<0.05), while the OS between CD19+ patients and CD19- patients was not significantly different. CONCLUSION: The bone marrow CD56+ in RUNX1-RUNX1T1 positive AML patients suggests poor prognosis. The CD19+ only correlates with CR1, but does not with OS.

[Effect of WT1 Gene High Expression and CD34+ and Auer+ on Prognosis of Acute Myeloid Leukemia].

OBJECTIVE: To explore the clinical significance of WT1 expression level in patient with AML non-M3,understand the biological characteristics of Auer+ and CD34+ AML and its effects on first induced remission rate and prognosis. METHODS: The RQ-PCR was used to detect the WT1 expression levels in 92 patients suffering AML non-M3; the relationship between the CR1 and OS was analysed and the differences of CR1 and OS in AML with Auer+ and Auer-,CD34+ and CD34- were compared. RESULTS: AML with WT1 high expression level at first visit had quite lower CR1 (P<0.05). AML with CD34+ had quite lower CR1 (P<0.05). Compared with Auer- patients, CR1 of Auer+ CML patients was higher (P<0.05), the OS of AML patients with WT1 high expression level was lower than that of the AML patients with low expression level of WT1, and with significant differences (P<0.05), the OS of AML patients with CD34+ was lower than that of AML patients with CD34-, and with significant differences (P<0.05). There was no obvious difference in OS between the AML patients with Auer+ and Auer-. CONCLUSION: High expression level of WT1 and CD34+ in AML patients suggests the poor prognosis. The Auer positive only relats with CR1, and does not relate with OS.