地西他滨对骨髓增生异常综合征/急性髓系白血病患者外周血及骨髓中调节性T细胞相对含量的影响研究

目的:通过分析应用地西他滨(DAC)治疗以及非DAC化疗的骨髓增生异常综合征(MDS)及急性髓系白血病(AML)患者外周血及骨髓中的调节性T细胞(Treg)的相对含量,探讨Treg在MDS及AML发病及缓解过程中的免疫调节功能,及DAC对其的影响。方法:收集2018年10月-2019年2月在昆明医科大学第一附属医院血液科就诊的MDS患者15例,AML患者49例,对照组14例(标本来自确诊的缺铁性贫血或巨幼细胞贫血患者,经系统检查排除恶性肿瘤及自身免疫性疾病)。采集入组患者的骨髓液及外周血进行流式检测Treg的相对含量,同时收集临床资料。结果:在初诊时MDS及AML患者外周血及骨髓中Treg相对含量较对照组升高(P=0.05,P=0.043)。经DAC治疗的AML患者外周血中Treg相对含量较初诊组及非DAC化疗组均明显降低(P<0.05)。DAC治疗缓解组骨髓及外周血中Treg含量较未缓解组降低(P<0.05)。DAC治疗组与对照组Treg含量无差异。结论:DAC可能通过消耗体内Treg含量,减少对机体抗肿瘤免疫的抑制,增强机体免疫功能对肿瘤细胞的识别及杀伤,从而促进患者疾病的缓解。

Effect of Decitabine on Regulatory T Cells Relative Content in Peripheral Blood and Bone Marrow of Patients with Myelodysplastic Syndrome/Acute Myeloid Leukemia

Objective:To investigate regulatory T cells(Tregs) relative content in peripheral blood and bone marrow of patients with myelodysplastic syndrome(MDS) and acute myeloid leukemia(AML) treated with or without decitabine(DAC),analyze the immunomodulatory of Tregs in pathogenesis and remission of MDS and AML,as well as effect of DAC on Tregs.Methods:From October 2018 to February 2019,15 patients with MDS and 49 patients with AML(newly diagnosed,treated with DAC or other chemotherapy regimens) were enrolled in this study,and 14 cases with iron deficiency or megaloblastic anemia while without malignant tumor and autoimmune disease as controls.The Tregs relative contents in bone marrow and peripheral blood were analyzed by flow cytometry,meanwhile clinical data of the objects were collected.Results:In peripheral blood and bone marrow of the patients with MDS and AML,the Tregs relative contents at newly diagnosed were higher than those of the control group(P=0.05,P=0.043).The Tregs relative content of AML patients in DAC regimen treatment group was significantly lower than that in the newly diagnosed group and non-DAC chemotherapy group(P<0.05).In DAC regimen treatment group,the Tregs relative contents was significantly lower in remission group than in non-remission group(P<0.05).There was no difference between DAC regimen treatment group and control group in Tregs relative content.Conclusion:DAC may increase the body’s antitumor immunity by consuming Tregs content,enhance the body’s immune function to identify and kill tumor cells,thereby promote the patients’ reliefs.