Children With Acute Lymphoblastic Leukemia Before And After Treatment Of Peripheral Blood T Cell Surface Ctla 4, The Expression Of Cd28

Objective:To investigate the expression of the costimulatory molecules CTLA-4and CD28in peripheral blood T lymphocytes and the relationship of these molecules with the development and treatment outcome in Children with Acute Lymphoblastic LecukemiaMethods:By FACS, the expression of the costimulatory molecules CTLA-4and CD28in peripheral blood T lymphocytes were detected in27children with newly diagnosed B cell precursor ALL at active phase and the VDLD program of treatment to achieve complete remission and sustained remission after discontinuation2～3weeks to consolidation.Results:①The level of CTLA-4on CD4+T cells and CD8+T cells of ALL before chemotherapy were higher than those in normal controls markedly(P<0.01);(2)The level of CD28on CD4+T cells and CD8+T cells of ALL before chemotherapy were lower than those in normal controls markedly(P<0.01);(3)Induced sensitive children with ALL achieve complete remission, the level of CTLA-4on CD4+T cells and CD8+T cells decreased significantly after chemotherapy compared with that before chemotherapy (P<0.01) and had no statistical significance after chemotherapy compared with that normal controls (P>0.05);④nduced sensitive children with ALL achieve complete remission, the level of CD28on CD4+T cells and CD8+T cells increased significantly after chemotherapy compared with that before chemotherapy (P<0.01) and had no statistical significance after chemotherapy compared with that normal controls (P>0.05);⑤nduced insensitive children with ALL achieve complete remission, the level of CTLA-4/CD28on CD4+T cells and D8+T cells had no statistical significance after chemotherapy compared with that normal controls.Conclusion:①he expression of CD28decreased and the expression of CTLA-4increased in Children with newly diagnosed B cell precursor ALL, suggesting that T lymphocytes can not be fully activated to reduce tumor immune surveillance and clearance,which may be one of the pathogenesis of ALL.②Induced sensitive children with ALL achieve complete remission, The level of CTLA-4/CD28return to normal and are still abnormal for induced insensitive children, suggesting that the relationship of T lymphocytes aberrant activation with the development in Children with ALL. leukemia cells produce immune closed factor,which can not be normal activation of T lymphocytes, tumor cells are easy to escape.③Focus on regulating the immune function of T lymphocytes and stimulating of T lymphocytes normal activation, which may help to improve ALL remission rate during ALL chemotherapy. In addition, the continued abnormal expression of CTLA-4/CD28may be one of the ALL adverse prognostic indicators.