白血病·淋巴瘤
白血病·淋巴瘤
백혈병·림파류
Journal of Leukemia & Lymphoma
2015年
8期
483-486
,共4页
白血病,粒细胞,慢性%PR1%细胞毒性T细胞%肿瘤免疫
白血病,粒細胞,慢性%PR1%細胞毒性T細胞%腫瘤免疫
백혈병,립세포,만성%PR1%세포독성T세포%종류면역
Leukemia,myelogenous,chronic%PR1%Cytotoxic T lymphocytes%Tumor immunity
目的 探讨PR1特异性细胞毒性T细胞(CTL)与HLA-A0201阳性慢性粒细胞白血病(CML)患者疗效及预后的关系,探讨是否可以应用PR1肽作为疗效达到停药试验标准患者的后续免疫治疗,从而维持长期缓解状态.方法 收集28例HLA-A0201阳性CML患者外周血,利用可溶性PR1-MHC-Ⅰ类四聚体技术及流式细胞术检测PR1特异性CTL存在与否、频率高低;比较不同治疗时间CML患者PR1特异性CTL表达的差异.结果 PR1特异性CTL频率与同期PCR(bcr-abl/abl)IS(IS:国际标准值)之间呈负相关(r=-0.658,P＜0.001).接受治疗3、6、9个月及1、2、3、4、5、6年的PR1特异性CTL频率分别为(0.06±0.02)％、(0.10±0.02)％、(0.14土0.02)％、(0.16±0.02)％、(0.20±0.03)％、(0.18±0.03)％、(0.18±0.01)％、(0.17±0.05)％、(0.18±0.03)％.治疗3、6、9个月的频率分别与其他时间点频率相比,差异均有统计学意义(均P＜ 0.05).治疗1年及以上的频率两两相比,差异均无统计学意义(均P＞0.05).伊马替尼400 mg 1次/d治疗3、6、9、12个月,Sokal评分高危组患者PR1特异性CTL频率低于低危组、中危组.结论 治疗效果显著的CML患者体内可持续检测到PR1特异性CTL,其与肿瘤负荷呈负相关,提示PR1特异性CTL可能与抗白血病细胞作用相关,为疗效获得持续稳定MR4-5及MR5.0的CML患者使用PR1肽疫苗作为后续免疫治疗提供了依据.
目的 探討PR1特異性細胞毒性T細胞(CTL)與HLA-A0201暘性慢性粒細胞白血病(CML)患者療效及預後的關繫,探討是否可以應用PR1肽作為療效達到停藥試驗標準患者的後續免疫治療,從而維持長期緩解狀態.方法 收集28例HLA-A0201暘性CML患者外週血,利用可溶性PR1-MHC-Ⅰ類四聚體技術及流式細胞術檢測PR1特異性CTL存在與否、頻率高低;比較不同治療時間CML患者PR1特異性CTL錶達的差異.結果 PR1特異性CTL頻率與同期PCR(bcr-abl/abl)IS(IS:國際標準值)之間呈負相關(r=-0.658,P＜0.001).接受治療3、6、9箇月及1、2、3、4、5、6年的PR1特異性CTL頻率分彆為(0.06±0.02)％、(0.10±0.02)％、(0.14土0.02)％、(0.16±0.02)％、(0.20±0.03)％、(0.18±0.03)％、(0.18±0.01)％、(0.17±0.05)％、(0.18±0.03)％.治療3、6、9箇月的頻率分彆與其他時間點頻率相比,差異均有統計學意義(均P＜ 0.05).治療1年及以上的頻率兩兩相比,差異均無統計學意義(均P＞0.05).伊馬替尼400 mg 1次/d治療3、6、9、12箇月,Sokal評分高危組患者PR1特異性CTL頻率低于低危組、中危組.結論 治療效果顯著的CML患者體內可持續檢測到PR1特異性CTL,其與腫瘤負荷呈負相關,提示PR1特異性CTL可能與抗白血病細胞作用相關,為療效穫得持續穩定MR4-5及MR5.0的CML患者使用PR1肽疫苗作為後續免疫治療提供瞭依據.
목적 탐토PR1특이성세포독성T세포(CTL)여HLA-A0201양성만성립세포백혈병(CML)환자료효급예후적관계,탐토시부가이응용PR1태작위료효체도정약시험표준환자적후속면역치료,종이유지장기완해상태.방법 수집28례HLA-A0201양성CML환자외주혈,이용가용성PR1-MHC-Ⅰ류사취체기술급류식세포술검측PR1특이성CTL존재여부、빈솔고저;비교불동치료시간CML환자PR1특이성CTL표체적차이.결과 PR1특이성CTL빈솔여동기PCR(bcr-abl/abl)IS(IS:국제표준치)지간정부상관(r=-0.658,P＜0.001).접수치료3、6、9개월급1、2、3、4、5、6년적PR1특이성CTL빈솔분별위(0.06±0.02)％、(0.10±0.02)％、(0.14토0.02)％、(0.16±0.02)％、(0.20±0.03)％、(0.18±0.03)％、(0.18±0.01)％、(0.17±0.05)％、(0.18±0.03)％.치료3、6、9개월적빈솔분별여기타시간점빈솔상비,차이균유통계학의의(균P＜ 0.05).치료1년급이상적빈솔량량상비,차이균무통계학의의(균P＞0.05).이마체니400 mg 1차/d치료3、6、9、12개월,Sokal평분고위조환자PR1특이성CTL빈솔저우저위조、중위조.결론 치료효과현저적CML환자체내가지속검측도PR1특이성CTL,기여종류부하정부상관,제시PR1특이성CTL가능여항백혈병세포작용상관,위료효획득지속은정MR4-5급MR5.0적CML환자사용PR1태역묘작위후속면역치료제공료의거.
Objective To evaluate the relationship between proportion of PR1 specific cytotoxic T lymphocytes (CTLs) in the peripheral blood and prognosis and curative effect in patients with HLA-A0201 positive chronic myelogenous leukemia (CML),and to discuss whether PR1 peptide could be used as the following immune therapeutic method for patients who had achieved the standard of stop treatment.Methods The soluble HLA-A0201/PR1 tetramer and flow cytometry were applied to determine the proportion and the frequency of PR1 specific CTLs in peripheral blood from 28 HLA-A0201 positive CML patients.The proportions were compared among different phases of patients.The correlations between the proportion of PR1 specific CTLs and clinical parameters were analyzed.Results There was a negative correlation between PR1 specific CTLs and PCR (bcr-abl/abl)Is (r =-0.658,P ＜ 0.001).The frequencies of PR1 specific CTLs at 3-month,6-month,9-month,12-month,2-year,3-year,4-year,5-year,6-year were (0.06±0.02) ％,(0.10± 0.02) ％,(0.14±0.02) ％,(0.16±0.02) ％,(0.20±0.03) ％,(0.18±0.03) ％,(0.18±0.01) ％,(0.17±0.05) ％ and (0.18±0.03) ％,respectively.The frequency of PR1 specific CTLs at 3-month,6-month or 9-month was statistically different compared with that of the other time spots (P ＜ 0.05),and there were no statistical differencies among the frequencies at 1-year,2-year,3-year,4-year,5-year,6-year (P ＞ 0.05).For patients treated with IM 400 mg qd,the frequency of PR1 specific CTLs in high-risk group was lower than that in low-risk or intermediate-risk groups.Conclusion PR1 specific CTLs can be detected in patients who achieved good curative effect,and is correlated with tumor burden,which indicates that PR1 specific CTLs may be related to the action of resisting leukemia and provide the evidence for PR1 peptide as a potential immune therapeutic schedule in patients who have achieved stable MR45 and MR50.
