Analysis The Lymphocyte Subset Of 56 Children With Hemophagocytic Syndrome

[Objective]To study the change of lymphocyte subsets in children with hemophagocytic syndrome and investigate its significance in early diagnostic and prognostic.[Method]We collected the medical records of children diagnosed as HPS in the Affiliated Children’s Hospital of Kunming Medical University from January 2014 to December 2015 and analysised the surface makers of the peripheral blood lymphocyte subsets (T lymphocyte’surface markers choosen CD3+,CD4+,CD8+,B lymphocyte "surface markers choosen CD19+,NK cell’surface markers choosen CD16+CD56+) of the objects by flow cytometry (FCM). Also all the HPS children were followed up by telephone and we used the software package of SPSS17.0 to statistic analysis;Besides the Kaplan-Meier method was employed to survival curves.The objects in this study were grouped as follows:(1)Illness group(group A):There were 56 cases of children enrolled into this group and all of them were diagnosed as HPS according to the HLH-2004 Guideline revised by International organizations cell association.(2)Self-control group (group B):There were 25 cases of children with HPS enrolled into this group and all of them were choosed from group A.Besides,they all ttreated with HLH-2004 chemotherapy regimens and were divided into group B1 and B2 accroding the treatment.(3)Control group(group C):We choose 71 healthy children into this group and exclude the diseases such as acute or chronic disease,allergic diseases and genetic disorders.Also all the family members were informed consent.(Results](1)When comparing the peripheral blood lymphocyte subsets of 56 HPS children with control group,the proportion of CD3+T and CD8+T lymphocytes significantly increased and the proportion of CD4+T lymphocytes,the NK cells and the CD4+/CD8+T lymphocyte decreased significantly,which all had statistically differences(p<0.05).But the proportion of CD19+B lymphocyte had no statistically significant difference compared with the control group (p>0.05);(2)When Comparing the peripheral blood lymphocyte subsets of 25 cases HPS children with control group before and after treatment.the proportion of CD8+T lymphocytes increased significantly;But the CD4+/CD8+T lymphocyte and the proportion of CD4+T lymphocytes and NK cell decreased significantly,which all had statistically difference(p<0.05);While comparing the peripheral blood lymphocyte subsets of 25 HPS children after treatment with before.the proportion of CD4+T lymphocytes and the CD4+/CD8+T lymphocyte increased significantly and the proportion of CD8+T lymphocytes decreased significantly, which all had statistically difference (p<0.05); However there was no statistically difference (p>0.05) between the proportion of CD3+T lymphocytes,the CD19+B lymphocyte and the NK cell.(4) All the HPS children from group A were followed up in total 706 days and the median follow-up time was 330 days;But there were 5 five patients died and two children’s time of death is unknown;Besides 12 patients gave up treatment and were lost.Also we found that the median follow-up time in normal and abnormal group of the CD3+T lymphocytes were277 day and 559 days; The median follow-up time in normal and abnormal group of the CD4+T lymphocytes were 559 days and 296 days; The median follow-up time in normal and abnormal group of the CD8+T lymphocytes were 319 days and 340 days; The median follow-up time in normal and abnormal group of the CD4+/CD8+T lymphocyte were 383 days and 441 days; The median follow-up time in normal and abnormal group of the NK cells were 266 days and 550 days;However the overall survival rate of the normal and abnormal groups of each lymphocyte subsets above-mentioned showed no significant difference(p> 0.05).[Conclusions](1)We considered that there existed immune disorder and the lymphocyte subsets disorder may play an important role in the diagnosis of the HPS children.(2)We considered the humoral disorder may have no significant effect in HPS.(3)The lymphocyte subsets disorder after treatment with HLH-2004 guidelines was improved, but the immune function of the patients were not fully recovered to normal level and may need further treatment.(4) There was no significant difference in the survival rate between the normal and abnormal group of lymphocyte subsets as fllows:the CD3+T lymphocytes,the CD8+T lymphocytes,the CD4+T lymphocytes,the CD4+/CD8+T lymphocytes and the NK cells;Thus reminded us that the lymphocyte subsets in the evaluation of the prognostic value needs further study.