Prognostic Value Of Peripheral Blood T Lymphocyte Subsets In Patients With Mantle Cell Lymphoma

Objective:To investigate the correlation of peripheral blood T lymphocyte subsets with overall survival and clinical baseline characteristics in mantle cell lymphoma（MCL）.Methods:The clinical data of 55 patients with MCL who were newly diagnosed in the Hematology Department of the Second Hospital of Shanxi Medical University from January 2012 to July 2022 were analyzed retrospectively.The percentage of T lymphocyte subsets and CD4⁺/CD8⁺ratio in peripheral blood were analyzed by flow cytometry.Theχ²test or Fisher’s exact test were used to analyze the relationship between T lymphocyte subsets in peripheral blood and clinical characteristics of patients;Kaplan-Meier method was used for survival analysis and survival curve was drawn.Log-Rank test is used to compare the survival curves.Univariate analysis was used to assess prognostic factors for OS,and Cox proportional hazards models were used for multivariate analysis.P-value of less than 0.05 indicates a statistical difference.Results:The median follow-up was 40 months（1-68 months）,and the median overall survival（OS）was 47 months.Among the 55 patients,30（54.55%）patients had decreased peripheral blood CD4⁺T lymphocytes,17（30.9%）patients had increased peripheral blood CD8⁺T lymphocytes,and 20（36.4%）patients had decreased CD4⁺/CD8⁺ratio.There was no significant correlation between CD4⁺/CD8⁺ratio and sex,age,Ki-67,B symptoms,leukocytes,hemoglobin,lymphocytes,platelets,albumin,LDH,β₂-MB,splenomegaly,bone marrow invasion,primary site and MIPI score.Survival analysis showed that patients with CD4⁺T cell>23.3%,CD8⁺T cell≤33.4%and CD4⁺/CD8⁺ratio>0.6 had longer OS,and the difference has a statistical difference（P=0.020,P<0.001,P<0.001）.Univariate analysis showed that Ki-67>30%（P=0.030）,LDH>250 U/L（P=0.016）,splenomegaly（P=0.028）,bone marrow involvement（P=0.032）,CD4⁺T cells≤23.3%（P=0.020）,CD8⁺T cells>33.4%（P<0.001）,CD4⁺/CD8⁺ratio≤0.6（P<0.001）were adverse prognostic factors affecting patients with OS.Multivariate analysis showed that CD4⁺/CD8⁺ratio≤0.6（HR=4.382,P=0.005）was an independent adverse prognostic factor for OS in MCL patients.Conclusion:1.In MCL,patients with a low CD4⁺/CD8⁺ratio had shorter OS than patients with a high CD4⁺/CD8⁺ratio.2.Low CD4⁺/CD8⁺ratio is associated with poor prognosis in MCL,and the CD4⁺/CD8⁺ratio can be used as an important indicator to evaluate the prognosis risk in patients of MCL.