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Regulatory T cells predict the time to initial treatment in early stage chronic lymphocytic leukemia
Author(s) -
Weiss Lukas,
Melchardt Thomas,
Egle Alexander,
Grabmer Christoph,
Greil Richard,
Tinhofer Inge
Publication year - 2010
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.25752
Subject(s) - medicine , chronic lymphocytic leukemia , cd38 , univariate analysis , gastroenterology , leukemia , proportional hazards model , immunology , stage (stratigraphy) , il 2 receptor , flow cytometry , oncology , multivariate analysis , t cell , immune system , cd34 , biology , stem cell , paleontology , genetics
Abstract BACKGROUND: Early stage chronic lymphocytic leukemia is characterized by a highly variable course of disease. Because it is believed that regulatory T cells (T regs ) are potent suppressors of antitumor immunity, the authors hypothesized that increased T regs may favor disease progression. METHODS: T reg levels (cluster of differentiation 3 [CD3]‐positive, [CD4]‐positive, CD25‐positive, and CD127‐negative) in peripheral blood from 102 patients were analyzed by flow cytometry. Statistical analysis was used to evaluate correlations with clinical data. RESULTS: The relative T reg numbers in CD4‐positive T cells were significantly greater in patients with chronic lymphocytic leukemia compared with the numbers in a control group of 170 healthy individuals ( P = .001). Patients were divided into 2 groups using a median T reg value of 9.7% (the percentage of CD4‐positive T cells). Patients with higher T reg levels had a significantly shorter time to initial treatment (median, 5.9 years) compared with patients who had lower T reg levels (median, 11.7 years; log‐rank P = .019). Furthermore, T reg levels (the percentage of CD4‐positive T cells) had significant prognostic power to predict the time to initial treatment in univariate analysis ( P = .023) and in multivariate Cox regression analysis that included the variables Rai stage, immunoglobulin heavy‐chain variable region gene mutational status, chromosomal aberrations, and CD38 expression ( P = .028). CONCLUSIONS: Higher T reg levels had significant and independent prognostic power for predicting the time to initial treatment in patients with low to intermediate stage chronic lymphocytic leukemia. Cancer 2011. © 2010 American Cancer Society.