Effect Of Different Chemotherapy On T Cell Subsets And Related Cytokines Of Patients With Multiple Myelom

Objectives:To investigate the effect of different chemotherapy on T cell subsets and related cytokines of patients with multiple myelom, and to provide a theoretical basis for the evaluation of curative effect and treatment schemeMETHODS:From Jun 2011 to Dec 2015, a total of 60 patients with multiple myelom which were diagnosed and treated in the department of hematology were recruited. All the patients were randomly divided into two groups(30 patients in each group). One group was treated with bortezomib in combination with dexamethasone(VD regimen) chemotherapy.The other group was treated with thalidomide combined with improved VAD method. The ratios of T helper 17 cells(TH17) and regulatory T cells(Treg cells) in the blood were detected by flow cytometry before and after treatment. The expression levels of IL-6, IL-17 and TGF-β in serum were determined by enzyme-linked immunosorbent assay(ELLESA).Results:1. The percentage of Treg cells in peripheral blood in Patients with MM was significantly lower than that of healthy control group. The proportion of cells in MM group increased significantly compared with the control group(P<0.05).2. Treg cell ratio in peripheral blood of MM patients at II stage and III stage was significantly lower than that in healthy control group. and Treg cell ratio in peripheral blood of MM patients at stage II and stage III was significantly lower than that in I patients(P<0.05). The percentage of Thl7 cells in peripheral blood in MM patients at different stages had no significant differences(P>0.05).3. The proportion of Treg cells in patients with MM after chemotherapy was significantly higher than that before treatment, and the proportion of Thl7 cells was lower than before chemotherapy, the difference was statistically significant(P<0.05).The comparion between Bortezomib group and thalidomide group, the proportion of TH17 cells in patients treated by Bortezomib was lower than that of after treatment by thalidomide(P<0.05). The proportion of Treg cells in patients treated by Bortezomib was higher than that of after treatment by thalidomide(P<0.05). The expression levels of IL-6 and IL-17 in patients treated by Bortezomib was lower than that of after treatment by thalidomide(P<0.05).4. The proportion of Treg cells in peripheral blood of MM patients with IgM type and IgG type was significantly higher than that before treatment, while the proportion of Thl7 cells was lower than before chemotherapy. For MM patients with IgA, the was only lower the proportion of Thl7 cells after chemotherapy(P<0.05).5. The expression levels of IL-6, IL-17 and TGF-β in serum of patients with MM were higher than that of healthy control group. After chemotherapy, The expression levels of IL-6, IL-17 and TGF-β in serum of patients with MM were significantly decreased, the difference was statistically significant(P<0.05). The expression levels of IL-6 and IL-17 in patients after treatment with Bortezomib were lower than that of patients after treatment with thalidomide(P<0.05).Conclusions:1. TH17 cells were significantly increased in blood of patients with MM, and Treg cells were significantly decreased in blood of patients with MM. The ratios of TH17 cells and Treg cells were significantly changed after treatment,which indicated that TH17 cells and Treg cells is not only related with the occurrence and development of MM,but also relate to patient’s condition and treatment effect.2. The expression levels of IL-6, IL-17 and TGF-β in serum had a certain correlation with progression and prognosis of MM patients, which could be the immunological indexes for MM diagnosis, severity evaluation and prognosis to provide reference.3. We presumed the using of bortezomib in combination with dexamethasone(VD regimen), which was prior to treatment with thalidomide combined with improved VAD method.