The Study Of T-Lymphocyte Subsets In Peripheral Blood Of Multiple Myeloma

Objective:To study the trend of T-Lymphocyte subsets in patients with multiple myeloma and to investigate the immune status and clinical significance of patients with multiple myeloma.Methods:We retrospectively analyzed 45 newly diagnosed multiple myeloma patients in our hospital from February 2015 to February 2017.Among them,ISS was divided according to the international staging system.There were 12 patients in stage I,20 in stage II,and 13 in stage III.Long-term follow-up after treatment,according to the state of the disease,there were 17 patients in stable period,16 patients in advanced stages,and12 patients were lost in contact.Statistics of T-cell subsets,serum?2-microglobulin(?2-MG),ratio of bone marrow plasma cells,lactate dehydrogenase(LDH),serum albumin(Albumin,ALB),and T-cell subsets,progression-free survival(PFS)and other clinical data after treatment were followed up to February 2018.T-Lymphocyte subsets of 25 healthy people in the physical examination center of our hospital were selected as the control group in the same time.The percentages of CD3~+,CD4~+,and CD8~+T cells and the ratio of CD4~+/CD8~+in peripheral blood of patients with multiple myeloma and healthy controls were analyzed.The percentages of CD3~+,CD4~+,and CD8~+T cells and the ratio of CD4~+/CD8~+cells in different ISS stages and after treatment were compared and analyzed for newly diagnosed multiple myeloma patients.The newly diagnosed MM patients were divided into normal and abnormal groups according to the ratio of CD4~+/CD8~+,and the correlation between different groups and ISS stage,LDH,bone marrow plasma cell ratio and progression-free survival was analyzed.Results:1.Compared with the control group:There was no significant difference in the percentages of CD3~+T cells and CD4~+T cells(t=0.188,P=0.852;t=-1.482,P=0.143);the percentages of CD8~+T cells was higher than that of the control group The difference was statistically significant(t=3.703,P<0.001);the ratio of CD4~+/CD8~+was lower than that of the control group,and the difference was statistically significant(t=-3.396,P=0.001).2.There was no significant difference in the percentages of CD3~+T cells between different clinical stages in MM patients with different clinical stages(F=0.110,P=0.896);the percentages of CD3~+T cells in each stage was not statistically different from that of the control group.Significance(P>0.05);There was a significant difference in CD4~+T cell ratio and CD4~+/CD8~+ratio in patients with different stages of MM(F=6.348,P=0.004;F=5.618,P=0.007); There was no significant difference in the percentages of CD8~+T cells in different stages of MM patients(F=1.396,P=0.259).The percentages of CD8~+T cells in stage III MM patients was increased,and the difference was statistically significant compared with the control group(P<0.001);The percentages of CD4~+T cells and the ratio of CD4~+/CD8~+in patients with stage III MM were both decreased,which was statistically significant compared with the control group(all P<0.05).3.Changes in T-Lymphocyte subsets of MM patients with different disease states after treatment,there was no significant difference in the ratio of CD3~+,CD4~+,CD8~+T cells,and CD4~+/CD8~+ratio between non-relapsed progressive group and control group(both P>0.05). Compared with the control group,the proportion of CD4~+T cells and the ratio of CD4~+/CD8~+decreased in relapse progression group,and the proportion of CD8~+T cells increased,and the difference was statistically significant(t=-4.283,P<0.001,t=5.539.(P<0.001,t=-6.502,P<0.001).The mean CD3~+T cell ratio decreased,but the difference was not statistically significant(t=-0.838,P=0.407). Compared with the non-relapsed progressive group and the relapsed progressive group,the proportion of patients with CD8~+T cells increased,and the difference was statistically significant(P<0.05).The proportion of CD4~+T cells and the ratio of CD4~+/CD8~+decreased mainly in the relapsed progressive group,and the difference was statistically significant(both P<0.05).4.The CD4~+/CD8~+ratio was divided into normal and abnormal groups at the time of initial diagnosis.The correlation between the different groups and the prognostic factors ISS stage,LDH,bone marrow plasma cell ratio,and PFS:CD4~+/CD8~+ratio in newly diagnosed MM patients is related to PFS(P<0.05)positive correlation.No correlation with other indicators(P>0.05) Conclusion:1.There are abnormal T-Lymphocyte subsets in the peripheral blood of patients with multiple myeloma.The proportion of CD8~+T cells increased and the ratio of CD4~+/CD8~+decreased,suggesting that the patient had a disorder of cellular immunity.2.The percentages of CD4~+T cells,the ratio of CD4~+/CD8~+,and the percentages of CD8~+T cells in patients with multiple myeloma decreased,which was most pronounced in stage III of ISS,suggesting that changes in T cell subsets are associated with disease severity.Patients with stage III have the greatest immune dysfunction.3.There was no significant difference in the percentages of CD3~+,CD4~+,CD8~+T cells and CD4~+/CD8~+ratio between the non-relapsed progressive group and the control group,suggesting that the patient's immune function recovered after treatment.Compared with the non-relapsed progressive group and the relapsed progressive group,the percentages of patients with CD8~+T cells increased,the percentages of CD4~+T cells,and the ratio of CD4~+/CD8~+decreased,and the difference was statistically significant,suggesting that the patient's immune dysfunction appeared again after the disease progressed.4.There was no correlation between the ratio of patients with CD4~+/CD8~+and the ratio of prognostic factors ISS stage,LDH,and bone marrow plasma cells in newly diagnosed patients(P>0.05),and may be related to the lack of clinical data.It is related to the small number of enrolled patients.It is necessary to expand the sample and analyze it again.CD4~+/CD8~+ratio was positively correlated with PFS in newly diagnosed MM patients,and patients with abnormal CD4~+/CD8~+ratio had a short-term survival without progression,cellular immunity had the weakest anti-tumor effect,and immunological disorders were the strongest.