Fludarabine and alemtuzumab are routinely used for treatment of B-cell chronic lymphocytic leukemia (B-CLL). The present study aimed to compare the expression of signaling molecules and cytokine production by T cells of B-CLL patients in long-term unmaintained remission/plateau phase following fludarabine or alemtuzumab treatment with that of indolent/untreated B-CLL patients and healthy donors. The frequency and intensity of TCR-CD3zeta chain, p56lck, p59fyn, ZAP-70, PI3-kinase and interferon (IFN)-gamma/interleukin (IL)-4 production in CD4 and CD8 T cells was examined by flow cytometry. T-cell function was assessed by stimulation with purified protein derivative (PPD) and phytohemagglutinin (PHA). Despite a reduction in number, the expression of IFN-gamma/IL-4 in T-cells in patients was significantly higher than in healthy donors. The intensity of most signaling molecules in treated patients was relatively unaffected vs. healthy donors but lower than untreated-indolent patients. However, the total number of T cells which expressed each of the signaling molecules was decreased in patients, with no difference between fludarabine- and alemtuzumab-treated patients. The T-cell response to PHA but not PPD was reduced in treated patients. The results suggest that, despite some alterations in signaling molecules and a reduction in T-cell number, overall T-cell functions may be relatively well preserved long-term after treatment with fludarabine and alemtuzumab.

译文

氟达拉滨和阿仑单抗通常用于治疗B细胞慢性淋巴细胞性白血病(B-CLL)。本研究旨在比较氟达拉滨或alemtuzumab治疗后长期未维持的缓解/高原期的B-CLL患者的信号分子的表达和T细胞的细胞因子产生与惰性/未经治疗的B-CLL患者和健康供体的长期比较。通过流式细胞术检测TCR-CD3zeta链,p56lck,p59fyn,ZAP-70,PI3-激酶和干扰素(IFN)-γ/白介素(IL)-4在CD4和CD8 T细胞中的产生频率和强度。通过用纯化的蛋白质衍生物(PPD)和植物血凝素(PHA)刺激来评估T细胞功能。尽管数量减少,但患者T细胞中IFN-γ/ IL-4的表达明显高于健康供体。与健康供体相比,已治疗患者中大多数信号分子的强度相对未受影响,但低于未治疗的惰性患者。但是,表达每种信号分子的T细胞总数在患者中减少了,在氟达拉滨和阿仑单抗治疗的患者之间没有差异。在治疗的患者中,对PHA而非TPD的T细胞反应降低。结果表明,尽管在用氟达拉滨和阿仑单抗治疗后,长期而言,尽管信号分子发生了某些变化并且T细胞数量有所减少,但总体T细胞功能仍可以得到较好的保留。

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