Prognostic significance of CD8 and CD4 T cells in chronic lymphocytic leukemia

Abstract

The prognostic value of the number of T cells and NK cells at diagnosis in CLL was analyzed in a cohort of 256 patients with CLL diagnosed between 1997 and 2007. Patients with leukemia showed elevated NK cells and T cell populations and CD4/CD8 ratio was inverted in 39.7% cases. Prognostic significance of lymphocytes was analyzed as a ratio of relative number of T cells to the size of the malignant monoclonal B-cell pool (T/NK cells:Malignant monoclonal B-cells ratio). Patients showed higher relative number of CD4 (p = 0.03), CD8 (p = 0.02), and NK cells (p = 0.01) in early Rai stage of disease. The multivariate Cox analysis identified the relative number of CD8 (hazard ratio (HR) = 1.464; p = 0.006) and CD4 T cells (HR = 0.091; p < 0.01) as independent predictors for survival. Additionally, patients with relative CD8 count > 0.074 or CD4 count > 0.1 had higher 10-year overall survival than patients with CD8 count ≤0.074 or CD4 count ≤0.1 (p = 0.002). Higher CD8 count was associated with significantly higher median time of survival of patients (149.33 vs. 82.06 months). Finally, association of the good prognostic factor of leukemia cells (CD38⁻ with high relative CD8 count identified a group of patients with an indolent clinical course with an overall survival probability at 10 years of 95%.

Expansion of a CD8+PD-1+ Replicative Senescence Phenotype in Early Stage CLL Patients Is Associated with Inverted CD4:CD8 Ratios and Disease Progression

“…However, profound defects in cell-mediated immunity are also a feature of this disease and patients usually have abnormalities in T-cell numbers and function (2)(3)(4)(5). Treatment with chemotherapy seems to exacerbate this problem by inducing T lymphopenia, thereby rendering patients more susceptible to infection (6).…”

Comparative analysis of CD4 and CD8 lymphocytes — evidences for different distribution in primary and secondary liver tumors

“…The ratios between CD4+ and CD8+ T lymphocytes within TILs are variable, depending not only on the investigated tumor type, but also on the quantification method. However, numerous studies on colorectal [9], ovarian [10], breast [11,12], and esophageal cancer [13], leukemia [14], and other malignancies confirmed the protective prognosis value of the immune infiltrate with CD8+ T lymphocytes [15]. Nevertheless, there are conflicting results, such as in melanoma, where TILs influence survival either positively [16,17] or negatively [18,19].…”

The PD-1/PD-L1 axis contributes to T-cell dysfunction in chronic lymphocytic leukemia

“…6,12 CD4 + and CD8 + T lymphocytes from CLL patients show distinct gene profiles, 13 with alterations in multiple genetic pathways, including the actin cytoskeleton.…”