目的 观察贝林妥欧治疗儿童难治/复发性急性B淋巴细胞白血病(B-acute lymphoblastic leukemia,BALL)7天时外周血CD19+B淋巴细胞计数、T淋巴细胞表面程序性死亡受体1(programmed death receptor 1,PD1)和肿瘤细胞表面程序性死亡配体1(programmed death ligand 1,PD-L1)表达水平.方法 回顾分析2021-09/2024-04月作者医院18例难治/复发性BALL患儿的临床资料,根据28天时微小残留病灶(minimal residual disease,MRD)结果将患儿分为MRD阴性组(n=15)和MRD阳性组(n=3).观察两组患儿使用贝林妥欧治疗前和治疗7天时外周血中T、B淋巴细胞计数及治疗前PD-1和PD-L1的表达水平.结果 与MRD阳性组比较,MRD阴性组患儿治疗7天时外周血B淋巴细胞数量显著下降(P＜0.001);MRD阴性组患儿治疗7天时外周血T、B淋巴细胞数量较治疗前显著下降(P＜0.001);MRD阳性组患儿治疗7天时外周血T、B淋巴细胞数量较治疗前有下降,但差异无统计学意义(P＞0.05).治疗前,MRD阳性组PD-1和PD-L1表达水平高于MRD阴性组,但差异无统计学意义(P＞0.05).结论 MRD阴性患儿在贝林妥欧治疗7天时外周血T、B淋巴细胞数量下降更明显.治疗前PD1/PD-L1在MRD阳性组表达有偏高趋势,但差异无统计学意义,提示较高水平PD-1/PD-L1可能影响贝林妥欧治疗效果.
Peripheral Blood B Lymphocyte Count and PD-1/PD-L1 Expression in Children with Refractory/Recurrent B-Acute Lympho-blastic Leukemia After Blinatumomab Treatment
Objective To observe the peripheral blood CD19+B lymphocyte count,T lymphocyte cell surface pro-grammed death receptor 1(PD1)and tumor cell surface programmed death ligand 1(PD-L1)expression levels in children with refractory/recurrent B-acute lymphoblastic leukemia(BALL)after 7 days of Blinatumomab treatment.Methods The data of refractory/recurrent BALL children who treated with Blinatumomab in author's hospital from September 2021 to April 2024 were retrospectively analyzed.According to the 28-day minimal residual disease(MRD)results,the children were divided into MRD negative group(n=15)and MRD positive group(n=3).The counts of T and B lymphocytes in peripheral blood before and 7 d after treatment in two groups were detected and the levels of PD-1 and PD-L1 before treat-ment were detected.Results Compared with MRD positive group,the number of peripheral blood B lymphocytes in MRD negative group significantly decreased after 7 d of treatment(P＜0.001);the number of T and B lymphocytes in peripheral blood of MRD negative group significantly decreased after 7 d treatment than those before treatment(P＜0.001);the number of T and B lymphocytes in peripheral blood of children in MRD positive group were decreased af-ter 7 d of treatment compared with that before,but there were no statistical significance before and after treatment(P＞0.05).Before treatment,the expression levels of PD-1 and PD-L1 in MRD positive group were higher than those in MRD negative group,but there were no statistical significance between the two groups(P＞0.05).Conclusion The number of T and B lymphocytes in peripheral blood of children with negative MRD decreases more significantly after 7 d with Blinatumomab treatment.Before treatment,the expression of PD1/PD-L1 showed a higher trend in the MRD posi-tive group,but the difference was not statistically significant,suggesting that a higher level of PD-1/PD-L1 may affectthe therapeutic effect of Blinatumomab.
BlinatumomabAcute B-acute lym-phoblastic leukemiaMinimal residual diseaseLymphocyte subgroupProgrammed death receptor 1Programmed death ligand 1
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