Immune Reconstitution after BTKi Treatment in Chronic Lymphocytic Leukemia

OBJECTIVE: To analyze the immune reconstitution after BTKi treatment in patients with chronic lymphocytic leukemia (CLL).

METHODS: The clinical and laboratorial data of 59 CLL patients admitted from January 2017 to March 2022 in Fujian Medical University Union Hospital were collected and analyzed retrospectively.

RESULTS: The median age of 59 CLL patients was 60.5(36-78). After one year of BTKi treatment, the CLL clones (CD5 +/CD19 +) of 51 cases (86.4%) were significantly reduced, in which the number of cloned-B cells decreased significantly from (46±6.1)×109/L to (2.3±0.4)×109/L (P =0.0013). But there was no significant change in the number of non-cloned B cells (CD19 + minus CD5 +/CD19 +). After BTKi treatment, IgA increased significantly from (0.75±0.09)g/L to (1.31±0.1)g/L (P <0.001), while IgG and IgM decreased from (8.1±0.2)g/L and (0.52±0.6)g/L to (7.1±0.1)g/L and (0.47±0.1)g/L, respectively (P <0.001, P =0.002). BTKi treatment resulted in a significant change in T cell subpopulation of CLL patients, which manifested as both a decrease in total number of T cells from (2.1±0.1)×109/L to (1.6±0.4)×109/L and NK/T cells from (0.11±0.1)×109/L to (0.07±0.01)×109/L (P =0.042, P =0.038), both an increase in number of CD4 + cells from (0.15±6.1)×109/L to (0.19±0.4)×109/L and CD8 + cells from (0.27±0.01)×109/L to (0.41±0.08)×109/L (both P <0.001). BTKi treatment also up-regulated the expression of interleukin (IL)-2 while down-regulated IL-4 and interferon (IFN)-γ. However, the expression of IL-6, IL-10, and tumor necrosis factor (TNF)-α did not change significantly. BTKi treatment could also restored the diversity of TCR and BCR in CLL patients, especially obviously in those patients with complete remission (CR) than those with partial remission (PR). Before and after BTKi treatment, Shannon index of TCR in patients with CR was 0.02±0.008 and 0.14±0.001 (P <0.001), while in patients with PR was 0.01±0.03 and 0.05±0.02 (P >0.05), respectively. Shannon index of BCR in patients with CR was 0.19±0.003 and 0.33±0.15 (P <0.001), while in patients with PR was 0.15±0.009 and 0.23±0.18 (P <0.05), respectively.

CONCLUSIONS: BTKi treatment can shrink the clone size in CLL patients, promote the expression of IgA, increase the number of functional T cells, and regulate the secretion of cytokines such as IL-2, IL-4, and IFN-γ. BTKi also promote the recovery of diversity of TCR and BCR. BTKi treatment contributes to the reconstitution of immune function in CLL patients.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:32

Enthalten in:

Zhongguo shi yan xue ye xue za zhi - 32(2024), 1 vom: 21. Feb., Seite 1-5

Sprache:

Chinesisch

Beteiligte Personen:

Wang, Yuan-Li [VerfasserIn]
Tang, Pei-Xia [VerfasserIn]
Chen, Kai-Li [VerfasserIn]
Guo, Guang-Yao [VerfasserIn]
Long, Jin-Lan [VerfasserIn]
Zou, Yang-Qing [VerfasserIn]
Liang, Hong-Yu [VerfasserIn]
Xu, Zhen-Shu [VerfasserIn]

Links:

Volltext

Themen:

207137-56-2
Bruton’s tyrosine kinase inhibitor
Chronic lymphocytic leukemia
English Abstract
Immune reconstitution
Immunoglobulin A
Interleukin-4
Journal Article
Receptors, Antigen, T-Cell
Retrospective study
Tumor Necrosis Factor-alpha

Anmerkungen:

Date Completed 26.02.2024

Date Revised 26.02.2024

published: Print

Citation Status MEDLINE

doi:

10.19746/j.cnki.issn.1009-2137.2024.01.001

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM36877886X