The Role Of Memory T Cells Subsets And Regulatory T Cells In Response And Prognosis Evaluation Of Multiple Myeloma

Objective and significance:1.Analyzing the memory T lymphocytes?T_m?and regulatory T cells?Tregs?status in multiple myeloma patients.2.Analyzing the T_m and Tregs in different treatment efficacy patients.3.Analyzing the effects of Bortezomib?BTZ?and Thalidomide?TM?on T_m and Tregs.4.To explore the clinical value of T_m subset and Tregs in response and prognisis evaluation.Methods:1.89 patients were enrolled in our study,among these,8 patients did not accepted treatment.Another patients were divided into effective??partial response?group?63 patients?and uneffective?<partial response?group?18 patients?according to the response.According to the treatment regimen they were divided into Bortezomib group and Thalidomide group.24 new diagnosied patients as baseline group,30 healthy were enrolled as control group.2.Flow Cytometry were applied to detect the percentage of Tm subsets and Tregs and automatic biochemistry analyzer was applied to detect the serum Alb??2-MG?LDH.Result:1.New diagnosied MM patients'T_CMM percent signifigantly decreased while T_CMM percent significantly increased.2.The percent of CD4⁺T_CM,CD8⁺T_CM and the ratio of CD8⁺T_CM/T_EMM in?PR group is significantly higher than baseline group?P<0.05?,while<PR group has no difference to baseline group?P>0.05?.The CD8⁺T_CM and the ratio of CD8⁺T_CM/T_EM are both significantly higher in?PR group than<PR group.And the ratio of Treg/CD4⁺T in?PR group are significantly higher than baseline group.3.In BTZ treatment group,the CD8⁺T_CM and the percentage of Tregs of CD4⁺T in?PR group is significantly higher than baseline group?P<0.05?,while in<PR group,had no significantly difference to baseline?P>0.05?.In TM group,the percentage of CD8⁺T_CM and Treg/CD4⁺T were significantly higher in?PR group than baseline?P<0.05?.The ratio of CD8⁺T_CM/T_EM in?PR group and healthy control group were obviously higher than baseline?P<0.05?.4.According to the ROC curve,A point closest to the upper left corner is taken as a critical value,at the value of 0.27,the sensitivity of evaluating the treatment effectiveness is 57.1%and the specificity is 94.1%.Results hints that the ratio of CD8⁺T_CM/T_EM may as one of the response evaluation indicator.5.Multiple myeloma patients'CD4⁺T_CM had a significant positive correlation to serum Alb?P<0.05?,and significant negative correlation to serum?2-MG?LDH?P<0.05?.6.The Treg absolute number had no significantly difference among?PR?<PR and baseline group.While the Treg/CD4⁺significantly increased in?PR group,hinting that Treg/CD4⁺may as one of the response evaluation indicator.Conclusions:1.The percentage of T_CM is significantly lower in multiple myeloma patients,and the percentage ofT_EM is higher,indicating that MM patients is in immune exhausted.2.The percentage of CD4⁺T_CM?CD8⁺T_CM and the ratio of CD8⁺T_CM/T_EM is significantly increased in effective treatment patients after Bortezomib or Thalidomide treatment,indicating that Bortezomib and Thalidomide could both reverse MM patients'immune exhausted state.3.When CD8⁺T_CM/T_EM<0.27,the specificity is 94.1%in evaluating no response.4.Peripheral blood CD4⁺T_CM could considered as one of the indicator in evaluating the response.5.Treg/CD4⁺is significantly increased in?PR group,hinting that Treg/CD4⁺may as one of the response evaluation indicator.