[Correlation of CD4⁺/CD8⁺Ratio in Peripheral Blood with Prognosis of Mantle Cell Lymphoma]

To investigate the correlation of peripheral blood T lymphocyte subsets with overall survival (OS) and clinical baseline characteristics in mantle cell lymphoma (MCL).

The clinical data of 55 MCL patients who were newly diagnosed in the Department of Hematology, Second Hospital of Shanxi Medical University from January 2012 to July 2022 were analyzed retrospectively. The percentages of T lymphocyte subsets and CD4⁺/CD8⁺ ratio in peripheral blood were detected by flow cytometry, and their correlation with clinical characteristics of patients were analyzed. Kaplan-Meier method was used for survival analysis and survival curves were drawn. Log-rank test was used for univariate analysis, while Cox proportional hazards model was used for multivariate analysis.

The median follow-up was 40(1-68) months, and the median overall survival (OS) was 47 months. Among the 55 patients, 30(54.5%) patients had a decrease in peripheral blood CD4⁺T lymphocyte, while 17(30.9%) patients had a increase in peripheral blood CD8⁺T lymphocyte, and 20(36.4%) patients had a decrease in CD4⁺/CD8⁺ ratio. There were no significant correlations between CD4⁺/CD8⁺ ratio and sex, age, Ki-67, B symptoms, leukocytes, hemoglobin, lymphocytes, platelets, albumin, lactate dehydrogenase (LDH), β₂-microglobulin, splenomegaly, bone marrow invasion, primary site and MIPI score. Survival analysis showed that patients with CD4⁺T cell >23.3%, CD8⁺T cell ≤33.4% and CD4⁺/CD8⁺ ratio >0.6 had longer OS (P =0.020, P <0.001, P <0.001). Univariate analysis showed that Ki-67>30%, LDH>250 U/L, splenomegaly, bone marrow involvement, CD4⁺T cells ≤23.3%, CD8⁺ T cells >33.4%, CD4⁺/CD8⁺ ratio ≤0.6 were adverse prognostic factors affecting OS of MCL patients. Multivariate analysis showed that CD4⁺/CD8⁺ ratio ≤0.6 (HR =4.382, P =0.005) was an independent adverse prognostic factor for OS of MCL patients.

Low CD4⁺/CD8⁺ ratio is associated with poor prognosis in MCL, and the CD4⁺/CD8⁺ ratio can be used as an important indicator to evaluate the prognosis risk in MCL patients.