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T‐helper phenotypes in the blood of myeloma patients on ECOG phase III trials E9486/E3A93
Author(s) -
Kay Neil E.,
Leong Traci,
Bone Nancy,
Kyle Robert A.,
Greipp Phillip R.,
Van Ness Brian,
Oken Martin M.
Publication year - 1998
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.1365-2141.1998.00609.x
Subject(s) - cd19 , multiple myeloma , flow cytometry , immunology , medicine , immune system , t cell , immunophenotyping , gastroenterology
T‐helper blood populations are frequently altered in multiple myeloma (MM). We measured the numbers of naive and activated cell subsets in the blood of a cohort of both previously untreated and treated MM patients. Two‐colour flow cytometry to detect total CD4 + , CD4 + , CD45RA + (naive) and CD4 + , CD45RO + (activated) subsets was then used to quantify the T‐cell subsets in controls and MM patients. Previously treated MM patients either on or off treatment ( n = 105) had significantly reduced ( P < 0.0001) total CD4 and naive/activated cells than controls. Previously treated MM patients sampled for naive/activated cells while currently off therapy ( n = 45) had no difference in the levels of CD4 and naive/activated cells compared to the currently treated patients ( n = 60). However, newly diagnosed patients ( n = 58) had a significantly reduced total CD4 ( P = 0.023) and activated CD4 ( P = 0.004), but not naive CD4 subsets, compared to controls. CD19 + cell levels above 125/μl were positively associated with higher T‐helper cell levels. There was a strong positive association for better overall survival for patients with > 395 CD4 cells/μl ( P = 0.0001). These data indicate that MM patients at diagnosis have altered T‐helper subsets, with a selective reduction in activated but not naive cells. Subsequent chemotherapy or the disease process contributes to a further reduction in CD4 cells. Importantly, the association of higher CD19 + cell levels with higher T helper cells indicates that certain myeloma patients can be identified with a more quantitatively intact immune system.