Plasmacytoid Dendritic Cell Infiltration in Acute Myeloid Leukemia.
Plasmacytoid Dendritic Cell Infiltration in Acute Myeloid Leukemia.
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急性髓系白血病的浆细胞样树突状细胞浸润
DOI：
10.2147/cmar.s260825
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发表时间：
2020
影响因子：
3.3
通讯作者：
Zhang X
中科院分区：
文献类型：
--
作者：
Zhu L;Wang P;Zhang W;Li Q;Xiong J;Li J;Deng X;Liu Y;Yang C;Kong P;Peng X;Zhong JF;Rao J;Zhang X
越来越多的证据表明，肿瘤微环境（TME）中的浆细胞样树突状细胞（PDCs）在肿瘤的发生和发展中发挥着重要作用。PDC浸润已在某些恶性肿瘤如经典霍奇金淋巴瘤和慢性粒单核细胞白血病中发现。我们的前期工作报道了急性髓系白血病（AML）可发生PDC浸润，但PDC在AML中的临床意义尚未得到深入研究。在这里，我们评估了在白血病微环境中PDC向AML转变的临床意义。应用流式细胞术检测了80例急性粒-单核细胞白血病（AML-M4）和83例急性单核细胞白血病（AML-M5）患者PDCs的频率。我们发现62例PDC浸润。这些患者表现出更高的骨髓原始细胞数量，更高的平均Hb浓度，并需要更多的化疗周期才能达到完全缓解（CR），但与无PDC浸润的患者相比，白色血细胞和血小板计数较低。药敏分析显示，PDC浸润患者对标准化疗方案的敏感性较低。Kaplan-Meier生存曲线显示，PDC浸润患者的总生存期（OS）和无进展生存期较短。这些结果表明PDC浸润可用于AML-M4/M5的危险分层，并且PDC可在AML微环境中转分化为白血病。
Increasing evidence has demonstrated that plasmacytoid dendritic cells (PDCs) in the tumor microenvironment (TME) play an important role in tumorigenesis and progression. PDC infiltration has been found in certain malignancies such as classic Hodgkin’s lymphoma and chronic myelomonocytic leukemia. Our previous work reported that PDC infiltration could occur in acute myeloid leukemia (AML), but the clinical significance of PDC in AML has not been thoroughly investigated. Here, we evaluated the clinical significance of PDC to AML transition in a leukemia microenvironment. The frequency of PDCs in 80 acute myelomonocytic leukemia (AML-M4) and 83 acute monocytic leukemia (AML-M5) patients was determined by flow cytometry. We found 62 cases with PDC infiltration. These patients showed higher numbers of bone marrow blasts, higher mean Hb concentration, and required more cycles of chemotherapy before achieving complete remission (CR), but had lower white blood cell and platelet counts compared to patients without PDC infiltration. Drug sensitivity analysis showed that patients with PDC infiltration had lower sensitivity to standard chemotherapy regimens. Kaplan–Meier survival curves demonstrated that patients with PDC infiltration had a shorter overall survival (OS) time and progression-free survival time. These results suggested that PDC infiltration can be used for risk stratification of AML-M4/M5, and PDCs may transdifferentiate into leukemia in an AML microenvironment.