SitemapContact Us
닫기
Search
Advanced Search +
닫기
Quick links
Most Cited Most Read Ahead of Print Archives Go to E-submission

Original Article

Split Viewer

Blood Res 2018; 53(3):

Published online September 28, 2018

https://doi.org/10.5045/br.2018.53.3.198

© The Korean Society of Hematology

The prognostic impact of lymphocyte subsets in newly diagnosed acute myeloid leukemia

Yumi Park1, Jinsook Lim1, Seonyoung Kim1, Ikchan Song2, Kyechul Kwon1, Sunhoe Koo1, and Jimyung Kim1*

Author Info. +

1Department of Laboratory Medicine, Chungnam National University Hospital, Daejeon, Korea.

2Department of Hemato-Oncology, Chungnam National University Hospital, Daejeon, Korea.

Correspondence to : Correspondence to Jimyung Kim, M.D. Department of Laboratory Medicine, Chungnam National University Hospital, 282 Moonhwa-ro, Joong-gu, Daejeon 35015, Korea. jmkim@cnuh.co.kr

Received: August 2, 2017; Revised: March 6, 2018; Accepted: May 10, 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Go to

Background

Tumor-infiltrating lymphocytes, which form a part of the host immune system, affect the development and progression of cancer. This study investigated whether subsets of lymphocytes reflecting host-tumor immunologic interactions are related to the prognosis of patients with acute myeloid leukemia (AML).

Methods

Lymphocyte subsets in the peripheral blood of 88 patients who were newly diagnosed with AML were analyzed by quantitative flow cytometry. The relationships of lymphocyte subsets with AML subtypes, genetic risk, and clinical courses were analyzed.

Results

The percentages of T and NK cells differed between patients with acute promyelocytic leukemia (APL) and those with AML with myelodysplasia-related changes. In non-APL, a high proportion of NK cells (>16.6%) was associated with a higher rate of death before remission (P=0.0438), whereas a low proportion of NK cells (≤9.4%) was associated with higher rates of adverse genetic abnormalities (P=0.0244) and relapse (P=0.0567). A multivariate analysis showed that the lymphocyte subsets were not independent predictors of survival.

Conclusion

Lymphocyte subsets at diagnosis differ between patients with different specific subtypes of AML. A low proportion of NK cells is associated with adverse genetic abnormalities, whereas a high proportion is related to death before remission. However, the proportion of NK cells may not show independent correlations with survival.

Keywords Acute myeloid leukemia, Lymphocyte subset, NK cells, Prognosis

Article

Original Article

Blood Res 2018; 53(3): 198-204

Published online September 28, 2018 https://doi.org/10.5045/br.2018.53.3.198

Copyright © The Korean Society of Hematology.

The prognostic impact of lymphocyte subsets in newly diagnosed acute myeloid leukemia

Yumi Park1, Jinsook Lim1, Seonyoung Kim1, Ikchan Song2, Kyechul Kwon1, Sunhoe Koo1, and Jimyung Kim1*

1Department of Laboratory Medicine, Chungnam National University Hospital, Daejeon, Korea.

2Department of Hemato-Oncology, Chungnam National University Hospital, Daejeon, Korea.

Correspondence to:Correspondence to Jimyung Kim, M.D. Department of Laboratory Medicine, Chungnam National University Hospital, 282 Moonhwa-ro, Joong-gu, Daejeon 35015, Korea. jmkim@cnuh.co.kr

Received: August 2, 2017; Revised: March 6, 2018; Accepted: May 10, 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

Tumor-infiltrating lymphocytes, which form a part of the host immune system, affect the development and progression of cancer. This study investigated whether subsets of lymphocytes reflecting host-tumor immunologic interactions are related to the prognosis of patients with acute myeloid leukemia (AML).

Methods

Lymphocyte subsets in the peripheral blood of 88 patients who were newly diagnosed with AML were analyzed by quantitative flow cytometry. The relationships of lymphocyte subsets with AML subtypes, genetic risk, and clinical courses were analyzed.

Results

The percentages of T and NK cells differed between patients with acute promyelocytic leukemia (APL) and those with AML with myelodysplasia-related changes. In non-APL, a high proportion of NK cells (>16.6%) was associated with a higher rate of death before remission (P=0.0438), whereas a low proportion of NK cells (≤9.4%) was associated with higher rates of adverse genetic abnormalities (P=0.0244) and relapse (P=0.0567). A multivariate analysis showed that the lymphocyte subsets were not independent predictors of survival.

Conclusion

Lymphocyte subsets at diagnosis differ between patients with different specific subtypes of AML. A low proportion of NK cells is associated with adverse genetic abnormalities, whereas a high proportion is related to death before remission. However, the proportion of NK cells may not show independent correlations with survival.

Keywords: Acute myeloid leukemia, Lymphocyte subset, NK cells, Prognosis

Fig 1.

Download
Figure 1.

Correlation between bone marrow blast percentage and NK cell percentage.

Blood Research 2018; 53: 198-204https://doi.org/10.5045/br.2018.53.3.198

Fig 2.

Download
Figure 2.

Kaplan-Meier plots of disease free survival (A) and overall survival (B) in the subgroups according to the NK cell percentages.

Blood Research 2018; 53: 198-204https://doi.org/10.5045/br.2018.53.3.198
Clinical and laboratory characteristics.

Continuous data are presented as median (range)..

Abbreviations: AML, acute myeloid leukemia; APL, acute promyelocytic leukemia; PBSCT, peripheral blood stem cell transplantation; WBC, white blood cell..
Frequency distribution of lymphocyte subsets in peripheral blood according to the AML subtypes at diagnosis.

a)Other AMLs excluded APL with t(15;17) and AML-MRC. b)AML with favorable risk excluded APL with t(15;17)..

Abbreviations: AML, acute myeloid leukemia; AML-MRC, acute myeloid leukemia with myelodysplasia-related changes; AML-NOS, acute myeloid leukemia, not otherwise specified; APL, acute promyelocytic leukemia; NK, natural killer..
Clinical and laboratory data of the groups based on the proportion of NK cells in treated 71 non-APL patients.

Continuous data are presented as median (range)..

Abbreviations: APL, acute promyelocytic leukemia; DFS, disease free survival; Hb, hemoglobin; NK, natural killer; OS, overall survival; PBSCT, peripheral blood stem cell transplantation; WBC, white blood cell..
Univariate and multivariate analyses to identify the factors affecting DFS and OS in 71 treated non-APL patients.

Continuous data are presented as median (range) and dichotomous data are presented as N (%)..

Abbreviations: APL, acute promyelocytic leukemia; BM, bone marrow; CI, confidence interval; DFS, disease free survival; HR, hazard ratio; NK, natural killer; OS, overall survival; PBSCT, peripheral blood stem cell transplantation; WBC, white blood cell..
Blood Res
Volume 59 2024
Current Issue Archives

Stats or Metrics

Share this article on

  • line

Related articles in BR

Blood Research

pISSN 2287-979X
eISSN 2288-0011
qr-code Download