| Objectives:Decitabine,as a demethylating drug,has achieved very good efficacy in the treatment of myelodysplastic syndrome and acute myeloid leukemia,and has been widely used in the treatment of solid tumors.The immunomodulatory effects of decitabine have recently been recognized.Both bone marrow-derived suppressor cells(MDSCs)and regulatory T cells(Tregs)are inhibitory immune cells which play an inhibitory role in the autoimmune response of the body.This topic focuses on the relative contents of MDSCs and Tregs in peripheral blood of patients with MDS and AML who were newly diagnosed,treated with decitabine,or non-decitabine.And the immunoregulatory mechanisms of MDSCs and Tregs in the pathogenesis of MDS and AML was explored.Then the effect of decitabine on immune regulation in patients with MDS and AML also was discussed.Methods:We collected patients admitted to the Department of Hematology of the First Affiliated Hospital of Kunming Medical University from October 2017 to March 2018.Among them.15 were MDS patients included in the MDSCs group.23 were AML patients,and 6 were in the control group(Peripheral blood samples were obtained from patients diagnosed with iron deficiency anemia in the Department of Hematology of the First Affiliated Hospital of Kunming Medical University,and application of gastroenteroscope to exclude digestive system tumors).13 were MDS patients included in the Tregs group,16 were AML patients,and 6 were in the control group(Peripheral blood samples were obtained from patients diagnosed with iron deficiency anemia in the Department of Hematology of the First Affiliated Hospital of Kunming Medical University.and application of gastroenteroscope to exclude digestive system tumors).3-4 ml of peripheral blood samples were collected from all enrolled patients.The fresh specimens were surface stained,hemolyzed,washed,centrifuged,and resuspended within 48 hours,followed by flow cytometric analysis to detect relative amounts of MDSCs and Tregs.At the same time,collect detailed clinical relevant data of all enrolled patients.The experimental data was analyzed by SPSS21.0 software,and P<0.05 indicated that the difference was statistically significant.Results:1.The relative content of MDSCs in peripheral blood of patients with newly diagnosed MDS and AML was significantly higher than that of patients with non-hematologic malignancy,and the difference was statistically significant(P=0.026,P=0.002).2.Compared with the newly diagnosed patients and non-DAC treated patients,the relative content of MDSCs in the peripheral blood of MDS patients treated with DAC was significantly decreased(P=0.046,P=0.014),and there was no statistical difference compared with the control group(P =0.343).3.The relative content of MDSCs in peripheral blood of DAC-treated AML patients was significantly lower than those of newly diagnosed patients and non-DAC-treated patients(P=0.012,P=0.027),and there was no significant difference compared with the control group(P = 0.533).4.In the peripheral blood of AML patients,the relative content of MDSCs in the DAC treatment remission group showed a significant downward trend compared with the non-remission group and non-DAC treatment remission group(P=0.031,P=0.017).5.The relative content of Tregs in the peripheral blood of AML patients was significantly higher than that of non-hematological malignancies,and the difference was statistically significant(P=0.028).6.However,in the study of relative content of Tregs in DAC,DAC was not found to have a significant effect on the relative content of Tregs.Conclusions:1.MDSCs and Tregs may be involved in the immune escape mechanisms in tumor patients with MDS and AML.2.DAC may reduce the inhibition of MDSCs on the body’s anti-tumor immunity through the consumption of MDSCs in vivo,and enhance the body’s recognition of tumor cells and the immune function of killing them.3.DAC treatment had no significant effect on the Tregs content in peripheral blood of patients with MDS and AML. |
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