Characteristics of fine lymphocyte typing in myelodysplastic syndrome
Objective To investigate the characteristics of fine lymphocyte typing in patients with myelodysplastic sydrome(MDS)and evaluate the changes of immune status during the course of MDS.Methods A retrospective study was conducted on 73 patients with MDS,including 47 males and 26 females,aged 66(56,73)years old,diagnosed at the First Affiliated Hospital of Nanjing Medical University from February 1,2022 to January 31,2024.Besides,30 healthy individuals from the Health Management Center were selected as the control group.The deep lymphocyte typing was detected by flow cytometry.The differences of lymphocyte subset distribution among the groups were compared;Spearman's rank correlation coefficient was used to analyze the correlation between lymphocyte subpopulation and blast cells or CD34+cells.Results As the risk level of revised International Prognostic Scoring System(IPSS-R)increased,the proportion of helper T(Th)cells(P=0.047)and naivesubpopulation(CD4+CD45RA+CD62L+)(P=0.021)in the low-risk group,middle-risk group,and high-risk group increased gradually,while memory subpopulation(CD4+CD45RA-)(P=0.007)gradually decreased;compared to the group with the low amount of gene mutations,the proportion of B lymphocyte cells(8.76％vs 18.41％,P=0.005)and late activated cytotoxic T lymphocyte(Tc)cells(CD8+HLADR+)(21.21％vs 31.69％,P=0.020)decreased in the high group,and natural killer(NK)cells increased(14.98％vs 8.94％,P=0.032).There was a correlation between the percentage of blast cells and the proportion of Th cells(P=0.022),naivesubpopulation(P=0.045),memory subpopulation(P=0.017),and highly activated Tc cells(CD8+CD38+HLADR+)(P=0.013).Conclusions In patients with MDS,the proportion of Th cells and naive subpopulations is increased,while that of memory subpopulations is decreased,which may indicate an increased risk of IPSS-R;the decreased proportion of B cells,late activated Tc cells,and the increased proportion of NK cells may suggest the accumulation of gene mutations.The differences of lymphocyte subpopulation distribution among MDS patients with different IPSS-R risk level and different amount of gene mutations,indicate that there is immune dysregulation during the course of MDS.Fine lymphocyte typing is helpful to evaluate the changes in immune function in MDS patients.
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