Portal de Periódicos da CAPES

T‐helper phenotypes in the blood of myeloma patients on ECOG phase III trials E9486/E3A93

1998; Wiley; Volume: 100; Issue: 3 Linguagem: Inglês

10.1046/j.1365-2141.1998.00609.x

1365-2141

Neil E. Kay, Traci Leong, Nancy D. Bone, Robert A. Kyle, Phillip Greipp, Brian Van Ness, Martin M. Oken,

T-cell and B-cell Immunology

T‐helper blood populations are frequently altered in multiple myeloma (MM). We measured the numbers of naive and activated cell subsets in the blood of a cohort of both previously untreated and treated MM patients. Two‐colour flow cytometry to detect total CD4 + , CD4 + , CD45RA + (naive) and CD4 + , CD45RO + (activated) subsets was then used to quantify the T‐cell subsets in controls and MM patients. Previously treated MM patients either on or off treatment ( n = 105) had significantly reduced ( P < 0.0001) total CD4 and naive/activated cells than controls. Previously treated MM patients sampled for naive/activated cells while currently off therapy ( n = 45) had no difference in the levels of CD4 and naive/activated cells compared to the currently treated patients ( n = 60). However, newly diagnosed patients ( n = 58) had a significantly reduced total CD4 ( P = 0.023) and activated CD4 ( P = 0.004), but not naive CD4 subsets, compared to controls. CD19 + cell levels above 125/μl were positively associated with higher T‐helper cell levels. There was a strong positive association for better overall survival for patients with > 395 CD4 cells/μl ( P = 0.0001). These data indicate that MM patients at diagnosis have altered T‐helper subsets, with a selective reduction in activated but not naive cells. Subsequent chemotherapy or the disease process contributes to a further reduction in CD4 cells. Importantly, the association of higher CD19 + cell levels with higher T helper cells indicates that certain myeloma patients can be identified with a more quantitatively intact immune system.