Purpose

There is paucity of data regarding T-cells in paediatric AML patients. The aim of this prospective study was to evaluate trend of T-cell subset during disease course of paediatric AML patients and to see its correlation with patient characteristics and survival outcome.

Methods

T-cell subsets (CD3, CD4 and CD8) were evaluated by flow-cytometry at diagnosis, post-induction, post-treatment completion, at 3 months and 6 months post-treatment completion, and relapse in 29 pediatric AML patients. Trend of T-cells was plotted between group A (those in continuous remission) and group B (those who relapsed) patients.

Results

Patients with high WBC count had significantly higher number of CD3, CD4 and CD8 cell. Baseline Tcell subsets did not affect CR, EFS and OS; however, higher than median CD4 count predicted improved DFS [58% vs 25%; HR = 0.306 (0.10–0.93); P = 0.037]. On serial follow-up from post-induction till 3 months after completion of therapy, there was no difference in the absolute values of T cell subsets between group A and B patients.

Conclusion

Our study demonstrated T cell subsets are increased in AML subjects with high WBC count. CD4 cells have a positive impact on DFS. Serial follow-up has no impact on T cell subsets. Further studies in larger patient cohorts are needed to evaluate if CD4 population may serve as an immune biomarker for AML.

中文翻译：

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小儿急性髓性白血病 T 细胞亚群的系列评估 - 一项前瞻性研究

目的

关于儿科 AML 患者 T 细胞的数据很少。这项前瞻性研究的目的是评估小儿 AML 患者病程中 T 细胞亚群的趋势，并了解其与患者特征和生存结果的相关性。

方法

在 29 名小儿 AML 患者的诊断、诱导后、治疗完成后、治疗完成后 3 个月和 6 个月以及复发时，通过流式细胞术评估 T 细胞亚群（CD3、CD4 和 CD8）。在 A 组（持续缓解的患者）和 B 组（复发的患者）患者之间绘制 T 细胞趋势。

结果

白细胞计数高的患者的 CD3、CD4 和 CD8 细胞数量明显增多。基线 Tcell 子集不影响 CR、EFS 和 OS；然而，高于中位数的 CD4 计数预示着改善的 DFS [58% 对 25%；HR = 0.306 (0.10–0.93)；P = 0.037]。在诱导后至治疗完成后 3 个月的连续随访中，A 组和 B 组患者的 T 细胞亚群绝对值没有差异。

结论

我们的研究表明，白细胞计数高的 AML 受试者的 T 细胞亚群增加。CD4 细胞对 DFS 有积极影响。连续随访对 T 细胞亚群没有影响。需要在更大的患者队列中进行进一步研究，以评估 CD4 群体是否可以作为 AML 的免疫生物标志物。