Immune Status of T Lymphocyte Subsets in Adults with Acute Myeloid Leukemia at Different Ages and Its Relationship with Prognosis
10.3870/j.issn.1672-0741.24.12.002
- VernacularTitle:不同年龄成人急性髓系白血病T淋巴细胞亚群免疫状态特点及与预后的关系
- Author:
Yuwan LV
1
;
Jishi WANG
1
Author Information
1. 贵州医科大学附属医院血液内科,贵阳 550001
- Publication Type:Journal Article
- Keywords:
acute myeloid leukemia;
T lymphocyte;
age;
immunity;
prognosis
- From:
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong
2025;54(4):571-578
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the immune status of T lymphocyte subsets in adults with acute myeloid leukemia(AML)across different age groups and its association with prognosis.Methods A total of 436 adult patients with AML admit-ted to the Affiliated Hospital of Guizhou Medical University from October 2015 to September 2023 were selected as study ob-jects.They were divided into 146 cases in the young group(>18 years old),170 cases in the middleage group(>35 years old),and 120 cases in the old group(>60 years old)according to age classification criteria.General data and laboratory indexes of the three groups were compared.Repeated-measures analysis of variance was used to compare the dynamic changes of CD3+,CD4+,CD8+,and CD4+/CD8+levels before and after treatment.Based on prognosis,patients were further categorized into good prognosis(n=96),medium prognosis(n=218)),and poor prognosis(n=122)groups.Multivariate logistic regression anal-ysis was used to analyze the relationship between T lymphocyte subsets and poor prognosis at different ages.Receiver operating characteristic curve(ROC)analysis was performed to assess the prognostic value of CD3+,CD4+,CD8+and CD4+/CD8+in un-treated AML patients.Results The levels of white blood cellcount(WBC),CD3+,CD4+,CD8+,CD4+/CD8+were the lowest in the elderly group,followed by themiddle-agedgroup,and thehighest in theyoung group.The levels of platelet(PLT)and lac-tate dehydrogenase(LDH)were the highest in the elderly group,followed by the middle-aged group,and lowest in the young group(all P<0.05).The results of repeated measures analysis of variance showed that differences in the timeeffect,intergroup effects,and interaction effects of CD3+,CD4+,CD8+,CD4+/CD8+levels among the three groups were statistically significant(all P<0.01).Multivariate Logistic regression analysis demonstrated that CD3+,CD4+,CD8+,and CD4+/CD8+were prog-nostic factors for AML patients in young,middle-aged and elderly groups(all P<0.05).The results of the ROC curve indicated that the individual detection of CD3+,CD4+,CD8+,CD4+/CD8+and the combined detection of all four indicators had certain predictive value for the occurrence of poor prognosis in AML patients in the young group,middle-aged group and elderly group(AUC>0.7).Conclusion Elderly patients exhibites low levels of CD3+,CD4+,CD8+,and CD4+/CD8+.These markers are i-dentified as critical factors influencing AML prognosis,with patients having low levels of these markers at higher risk of poor prognosis.
