| Objectives:By analyzing the expression changes of T,B lymphocytes and NK cell subsets before and after treatment in patients with multiple myeloma,the relationship between lymphocyte subsets and multiple myeloma was explored,which provided a theoretical basis for evaluating efficacy and guiding treatment.Methods:The clinical data of 51 patients with multiple myeloma(MM)admitted to the Department of Hematology,Changzhou First People's Hospital from January 2012 to December 2018 were collected and grouped according to the results of initial diagnosis,before and after chemotherapy,and different efficacy results.Differences in distribution of T,B lymphocytes and NK cell subsets between groups.Flow cytometry was used to detect the proportion of T lymphocytes,B lymphocyte subsets and NK cells in the blood of MM patients at the time of initial diagnosis and before and after treatment.Twenty groups of healthy subjects were used as the control group.All statistical analyses were performed using SPSS 22.0 software.The data were expressed as mean±standard deviation or median(quartile),and analyzed by t test and non-parametric test according to whether the data was normally distributed.P<0.05 was statistically significant.Results:1.Proportion of T cell subsets in 51 patients with multiple myeloma at the time of initial diagnosis:percentage of CD3+,CD4+,CD8+,CD4/CD8,CD3+HLA-DR+,CD3+CD25+,CD3+CD69+,and CD4+CD25+CD127+cells They are:68.47±10.25,39.27±7.27,31.19±9.96,1.45±0.68,22.39±8.97,10.12±6.88,2.88±2.25 and 5.37±2.84.Among them,21 patients underwent pre-and post-chemotherapy data.The proportion of T cell subsets before chemotherapy:CD3+,CD4+,CD8+,CD4/CD8,CD3+HLA-DR+,CD3+CD25+,CD3+CD69+and CD4+CD25+CD127+cells They are:70.58±9.83,38.18±6.26,33.41±9.77,1.28±0.53,23.38±11.06,7.54±4.66,2.19±1.15,4.95±1.86.The proportion of T cell subsets after chemotherapy for 4 courses:CD3+,CD4+,CD8+,CD4/CD8,CD3+HLA-DR+,CD3+CD25+,CD3+CD69+and CD4+CD25+CD127+percentage:74.06±8.41,39.21±8.55 36.83±8.24,1.16±0.51,36.09±10.50,9.65±7.08,1.59±1.10 and 6.09±3.82.Among all T cell subsets,significant changes occurred before and after chemotherapy were CD8?(33.41±9.77 vs.36.83±8.24,p=0.026)and CD3+HLA-DR+(23.38±11.06 vs.36.09±10.50,p=0.000)cell ratio,while other cell subpopulations including CD3+,CD4+,CD4/CD8,CD3+CD25+,CD3+CD69+,and CD4+CD25+CD127+ cells did not change significantly before and after chemotherapy.In 51 patients with multiple myeloma,the proportion of B cell subsets at the time of initial diagnosis:CD19+,CD20+,CD23+,CD3-HLA-DR+,CD19+CD23+ and CD19+CD5+ cells were 8.29±5.56,11.52±5.80,5.58±8.90,16.36±7.21,3.18±3.47 and 3.01±2.92.Among them,21 patients underwent pre-and post-chemotherapy data.The percentage of B cell subsets before chemotherapy:CD 19+,CD20+,CD23+,CD3-HLA-DR+,CD19+CD23+and CD19+CD5+cells were:7.77±6.15,1.89±6.09,4.34±4.11,16.00±8.22,2.82±3.61,3.00±3.30.The proportion of B cell subsets after chemotherapy for 4 courses:CD 19+,CD20+,CD23+,CD3-HLA-DR+,CD 19+CD23+and CD19+CD5+cells:4.80+4.98,6.10±5.65,1.95±2.57,12.75±6.31 1.57±2.36 and 2.13±2.30.Among all B cell subsets,significant changes occurred before and after chemotherapy were CD19+(7.77±6.15 vs.4.80±4.98,p=0.046),CD20+(11.89±6.09 vs.6.10±5.65,p=0.000),CD23+(4.34±4.11 vs.1.95±2.57,p=0.009),CD3-HLA-DR+(16.00±8.22 vs.12.75±6.31,p=0.013)cell ratio,while other cell subpopulations included D19+(total B cells),CD19+CD23+ and CD19+CD5+ cells showed no significant changes before and after chemotherapy.In 51 patients with multiple myeloma,the percentage of NK cells at the time of initial diagnosis was 16.29±10.74.Twenty-one patients underwent pre-and post-chemotherapy data.The percentage of NK cells before chemotherapy was 15.72±8.37,and the percentage of NK cells after chemotherapy was 13.70±6.88.There was no significant difference between pre-and post-chemotherapy(p=0.157).There were no significant differences in the distribution of T,B lymphocytes and NK cell subsets in NR,PR and CR groups in 51 patients with multiple myeloma.Conclusions:T cells and activated T cells were significantly elevated in the blood of MM patients.Treg cells were significantly reduced in the blood of MM patients,and there were significant changes after treatment,suggesting that activated T cells and Treg cells are not only related to the occurrence and development of MM,but also It is related to the patient's condition and treatment effect.CD19+B cells and CD20+B cells were significantly elevated in the blood of MM patients.Type ? allergy-mediated molecules were significantly reduced in the blood of MM patients,and there were significant changes after treatment,suggesting that these cells and molecules were activated not only with MM.It is related to the occurrence and development of the patient,and is also related to the patient's condition and treatment effect. |
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