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Objective:To analyze the expression of CD27 on T lymphocytes in the microenvironment of multiple myeloma (MM), and explore whether CD27 level or the CD27-/CD27+ ratio of T-cell affect the prognosis of MM patients.Methods:A total number of 103 newly-diagnosed MM patients from January 2016 to June 2019 were enrolled in the Affiliated Cancer Hospital of Harbin Medical University. All patients received bortezomib-based three-drugs combination regimen. The expression of CD27 on T lymphocytes in bone marrow aspirate samples was detected by flow cytometry before any treatment. MM patients were divided into two groups according to the CD27 level: CD27-high expression group (CD27 expression on T-cells ≥20%) and CD27-low expression group (CD27 expression on T-cells <20%). The clinical characteristics, treatment response and prognosis of patients between the two groups were analyzed using χ 2-test. The survival and clinical information of patients were compared using Kaplan-Meier method, and the related factors related to the survival of MM were analyzed using Cox proportional risk model. Results:Among 103 MM patients, 68 cases (66.0%) were included in CD27 high expression group, and 35 cases (34.0%) were included in low expression group. The percentage of bone marrow plasma cells and β2-MG level in CD27 high expression group were higher than those in CD27 low expression group significantly (54.4% [37/68] vs 22.9% [8/35], χ2=9.352, P=0.002;58.8% [40/68] vs 37.1% [13/35], χ2=4.348, P=0.037), and the proportion of ISS stage Ⅱ-Ⅲ in CD27 high expression group was higher than the counterpart (79.4% [54/68] vs 60% [21/35], χ2=4.399, P=0.036). After 4 cycles of three-drug combination therapy, the overall response rate ( ORR=stringent complete response+complete response+very good partial response+partial response) of the low CD27 expression group was higher than the high expression group (82.9% [29/35] vs 38.2% [26/68], χ2=18.489, P<0.01). The deep response rate to treatment (stringent complete response+complete response+very good partial response) was higher (48.6% [17/35] vs 27.9% [19/68], χ2=4.326, P=0.038), and the progression, free surviva (PFS) was longer (21months vs.14.1months, t=18.655, P<0.001) in the low expression group compared with CD27-high group. Univariate analysis showed that CD27-/CD27+T lymphocyte ratio, ISS stage Ⅱ-Ⅲ, age ≥65 years, β2-Mg ≥3.5 mg/L, and plasma cell proportion ≥30% were associated with the poor prognosis of MM patients, and the differences were significant statistically ( P<0.05). Multivariate analysis showed that CD27-/CD27+T lymphocyte ratio was an independent prognostic factor for 2-year overall survival (OS)( HR=2.425, 95% CI 1.216-4.835, P=0.012) and 2-year PFS ( HR=1.881, 95% CI 1.085-3.260, P=0.024) in MM patients. Conclusions:The expression of CD27 in T lymphocytes is correlated with the prognosis, treatment response and progression-free survival of MM. The ratio of CD27-/CD27+T lymphocytes is an independent prognostic indicator.
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Objective To investigate the expression and clinical significance of soluble E-cadherin (sE-cad) and E-cadherin (E-cad) in acute leukemia (AL), and to explore their relationship with the pathogenesis,development and diagnosis of extra-myeloid leukemia. Methods 87 newly diagnosed or relapsed AL patients (19 cases of L1, 29 L2, 14 M2, 20 M3, 4 M4, 1 M5) were collected from hospitalized patients in hematology department of Harbin Medical University Cancer Hospital. The plasma from 20 healthy volunteers was used as control group. The bone marrow was from 15 non-AL patients hospitalized in hematology department (7 cases of thrombocytopenic purpura, 4 iron deficiency anemia, and 4 fever). The expression of sE-cad in the plasma of 47 patients and 20 healthy volunteers was detected by ELISA; the expression of E-cad on the membrane surface of bone marrow MNC in 40 patients and 15 controls was determined by flow cytometry. Results The plasma level of sE-cad in AL group was significantly higher than that in healthy control group [(66.812±52.712) ng/ml vs. (17.976±14.206) ng/ml, P<0.01]. The plasma level of sE-cad in extra-myeloid infiltration AL group was significantly higher than that in no-extra-myeloid infiltration AL group [(83.545±60.759) ng/ml vs. (42.152±22.043) ng/ml, P<0.01]. The plasma level of sE-cad in high leukocytes AL group was higher than that in no-high leukocytes AL group [(85.166±57.828) ng/ml vs. (41.933±32.064) ng/ml, P<0.05]. The percentage of E-cad expression in AL group was significantly lower than that in control group [(13.615±14.038) % vs. (31.700±16.213) %, P<0.01]. The percentage of E-cad expression in no-extra-myeloid infiltration AL group was significantly higher than that in extra-myeloid leukemia infiltration AL group[(18.691±14.917) % vs. (6.589±8.959) %,P<0.01]. The percentage of E-cad in no-high-leukocytes AL group was significantly higher in high leukocytes AL group [(20.925±12.081) % vs. (7.446±11.118) %, P<0.01]. Conclusions The expression of E-cad on the membrane surface of bone marrow MNC and the expression of sE-cad in plasma may be closely associated with the occurrence of extra-myeloid leukemia and leukocytosis, which may be one of the important molecular mechanisms of leukemic cell infiltration and leukocytosis. High expression of sE-cad in plasma can be treated as one of index to diagnose extra-myeloid leukemia.
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Objective To evaluate immune function of patients with multiple myeloma ( MM) by detect the changes of the Treg cells in bone marrow of patients with MM .Methods Treg cells in peripheral blood and bone marrow of 45 patients with MM and 15 healthy controls were measured by flow cytometry .Results The per-centage of Treg cells in peripheral blood of MM was higher than that in healthy person ;The percentage of Treg cells in MM bone marrow was lower than that in healthy person ,and the extent was positively correlated with the level of β2-MG and ISS(P<0.05).Conclusion MM Patients display an abnormal level of CD 4 +CD25 +Treg cells,which may be an important mechanism of MM immune deficiency .