The Clinical Significance Of Subgroups Of T Lymphocyte And Fusion Gene Of BCR/ABL^IS Of Chronic Myeloid Leukemia Patients During TKIs Therapy

Objective:By detecting the fusion gene of BCR/ABL in simultaneous peripheral blood(PB) and bone marrow(BM) of chronic myeloid leukemia (CML), Observing the changes of PB and BM BCR/ABLIS. Wether it is possible that detecte BCR/ABLIS in PB rather than BM. At the same time detecting T lymphocyte subsets in PB of cellular immunological indexes. Analyzing the relationship of T lymphocyte subsets and BCR/ABLIS. Exploring the value of cellular immunological indexes in CML patients, looking for more indexes of convert the treatment of TKIs.Methods:Between April 2015 and March 2016 of CML patients admitted in our department as the research object, all TKIs treatment, the total of 38 cases of patients, CP (n= 30)、AP (n= 8). Using real-time quantitative polymerase chain reaction (RQ-PCR) technology to detect BCR/ABLIS in CML patients PB and BM, flow cytometry detecte T lymphocyte subsets in PB. All CML patients by the zero and after TKIs treatment of the third、sixth、twelfth、eighteenth and twenty-fourth month grouping. Analyzing the changes of each group of BCR/ABLIS in simultaneous PB and BM. Comparing the changes of T lymphocyte subsets before and after the TKIs treatment. Analyzing the correlation of T lymphocyte subsets and BCR/ABLIS in BM and PB. Twenty cases of newly diagnosed (CP=12、AP=8), calculating the Sokal integral (low risk, moderate risk and high risk), then divided into three groups. Analyzing the correlation of BCR/ABLIS in BM、T lymphocyte subsets and the risk stratification.Results:1.The relationship of fusion gene of BCR/ABLIS in simultaneous PB and BM duting different groups:the changes of the newly diagnosed,third and sixth month has statistical significance(P<0.01)； during the twelfth.eighteenth and twenty-fourth month the difference has no statistically significant(P>0.05)；After TKIs treatment three months the BCR/ABLIS of PB and BM was strong positive correlation(r>0.8),the difference has statistically significant(P<0.01).2.The changes of T lymphocyte subsets in PB:after six months of TKIs treatment the CD3+% and CD3+ CD8+% was decreased than newly diagnosed,after 18 months of treatment the CD4+/CD8+ was higher than newly diagnosed.However, before and after TKIs treatment the difference of CD3+CD4+% had no statistical significance(P>0.05).3.The correlation of T lymphocyte subgroup and BCR/ABLIS in BM:BM BCR/ABLIS and CD3+%、CD3+CD4+% of the newly diagnosed patients exist positive correlation,the difference has statistically significant(P<0.05);but with CD3+CD8+% and CD4+/CD8+ has no correlation,the difference has no statistically (P>0.05).After the third.sixth.twelfth.eighteenth and twenty-fourth month of TKIs treatment,the difference of BCR/ABLIS in BM and T lymphocyte subgroup has no statistically significant(P>0.05).4.The correlation of T lymphocyte subgroup and BCR/ABLIS in PB:The BCR/ABLIS in PB and T lymphocyte subgroup during each group hss no correlation, there was no statistically significant(P>0.05).5.The correlation of T lymphocyte subgroup and Sokalintegral:With the Sokal integral increased of the newly diagnosed patients,CD3+%、CD3+CD4+%、 CD3+CD8+% was more higher,the difference has statistically significant(P<0.05). But there was no correlation between CD4+/CD8+ and Sokal integral and the difference has no statistically(p>0.05).Conclusions:1、When the time of TKIs treatment more than 1 year and had better effect. We could consider to collect PB instead of BM to detect BCR/ABLIS level, then assess disease.2、TKIs could inhibit cellular immune function in CML patients. After treatment six months the percentage of CD3+and CD3+CD8+in PB significantly lower than newly diagnosed.3、With the higher of Sokal stratification in the newly diagnosed patients, the percentage of CD3+、CD3+CD4+ and CD3+CD8+ was higher. There was a liner relationship between tumor load and cellular immunological, provided proof to predicte the risk of relapse after TKIs withdrawal.