Extraordinarily elevated CD33 expression in CD56(+)CD3(-) cells in the bone marrow of a patient with relapsed acute myeloid leukemia: a case report.
Extraordinarily elevated CD33 expression in CD56(+)CD3(-) cells in the bone marrow of a patient with relapsed acute myeloid leukemia: a case report.
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CD56（+）CD3（ - ）细胞在患有复发急性髓样白血病的患者的CD3（ - ）细胞中的CD33表达非常高。
DOI：
10.21037/tcr-21-733
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发表时间：
2021-11
影响因子：
0.9
通讯作者：
Sun Z
中科院分区：
文献类型：
--
作者：
Wang D;Geng L;Liu H;Fang Y;Sun Z
基于遗传风险，异基因干细胞移植（allo-SCT）是某些形式的急性髓细胞白血病（AML）的唯一治愈性治疗。然而，移植后复发仍然是移植失败的常见原因。自然杀伤（NK）细胞和CD 8 + T细胞是重要的效应淋巴细胞，在肿瘤监视和抗肿瘤免疫应答中具有关键作用。在这项研究中，一名14岁的女性AML患者接受了异基因外周血干细胞移植（allo-PBSCT）治疗。6个月后骨髓复发。此后，患者接受DAE（柔红霉素、阿糖胞苷和依托泊苷）治疗，随后接受IAE（伊达比星、阿糖胞苷和依托泊苷）治疗，然后接受MA（米托蒽醌和阿糖胞苷）方案治疗。通过瑞姬染色、细胞遗传学分析和流式细胞术等一系列实验研究患者的特征。尽管DAE方案后有短暂缓解，但患者在完成MA方案后再次复发。骨髓中的CD 56 + CD 3-细胞表现出严重受损的激活和抗肿瘤功能，而CD 33表达则异常增加。此外，多功能效应CD 8 + T细胞的比例保持稳定，尽管它们具有高PD-1表达。这些发现揭示了异常的CD 56 + CD 3-细胞的功能障碍，高表达的CD 33，这可能是有针对性的，并与AML的复发/难治性allo-SCT后。
Based on genetic risk allogeneic stem cell transplantation (allo-SCT) is the only curative treatment for some forms of acute myeloid leukemia (AML). However, post-transplantation relapse remains a frequent cause of transplantation failure. Natural killer (NK) cells and CD8+ T cells are important effector lymphocytes with pivotal roles in tumor surveillance and anti-tumor immune response. In this study, a 14-year-old female patient with AML was treated with allogeneic peripheral blood stem cell transplantation (allo-PBSCT). Bone marrow relapse was found 6 months later. Thereafter, the patient was treated with DAE (daunorubicin, cytosine arabinoside, and etoposide), followed by IAE (idarubicin, cytosine arabinoside, and etoposide), and then MA (mitoxantrone and cytosine arabinoside) regimens. A series of experiments including Wright-Giemsa stain analyses, cytogenetic analysis and flow cytometry were conducted to investigate the characteristic of the patient. Although there was a short remission after the DAE regimen, the patient experienced another relapse after finishing the MA regimen. The CD56+CD3‒ cells in the bone marrow showed severely impaired activation and anti-tumor function, while extraordinarily increased CD33 expression. Moreover, the proportion of multifunctional effector CD8+ T cells remained stable, though they had high PD-1 expression. These findings revealed the dysfunction of abnormal CD56+CD3– cells with high CD33 expression, which might be targetable and related to the relapsed/refractory AML after allo-SCT.