[Memory B (CD5⁺ CD19⁺ CD27⁺) lymphocyte in patients with immune-related pancytopenia]
Yihao Wang1, Rong Fu1, Hui Liu1
1Department of Hematology, General Hospital,Tianjin Medical University,Tianjin 300052, China.
Insights
Memory B lymphocytes (Bm) in peripheral blood are elevated in relapsed immune-related pancytopenia (IRP). Rituximab (RTX) effectively eliminates Bm, unlike conventional therapy, indicating its potential for treating relapsed IRP.
Area of Science:
- Hematology
- Immunology
- Oncology
Background:
- Immune-related pancytopenia (IRP) is a complex hematological disorder.
- Identifying specific lymphocyte subsets involved in IRP pathogenesis is crucial for effective treatment strategies.
Purpose of the Study:
- To investigate the presence and significance of memory B lymphocytes (Bm) in the peripheral blood of patients with IRP.
- To evaluate the therapeutic efficacy of Rituximab (RTX) and conventional immunosuppression on Bm levels in relapsed IRP.
Main Methods:
- Fluorescence-activated cell sorting was used to quantify Bm (CD5⁺ CD19⁺ CD27⁺) in peripheral blood of 86 IRP patients and 11 healthy volunteers.
- Bone marrow mononuclear cell antibodies (BMMNC-Ab) were analyzed.
- Clinical outcomes and treatment responses were correlated with Bm levels.
Main Results:
- Elevated peripheral blood Bm levels were observed in relapsed IRP patients compared to initial IRP patients and healthy controls.
- Rituximab (RTX) treatment significantly reduced Bm levels in relapsed IRP patients.
- RTX demonstrated superior efficacy in eliminating Bm compared to conventional immunosuppression therapy.
- Lower initial Bm levels were associated with a higher risk of relapse within two years.
Conclusions:
- Peripheral blood Bm levels are a potential biomarker for relapse in IRP.
- Memory B lymphocytes are resistant to conventional immunosuppression but responsive to RTX.
- RTX offers a promising therapeutic option for relapsed IRP, particularly in cases refractory to standard treatments.
Objective:
To detect memory B lymphocyte (Bm) in peripheral blood (PB) of immune-related pancytopenia (IRP).
Methods:
86 patients with IRP and 11 health volunteers were enrolled in this study. Bm (CD5⁺ CD19⁺ CD27⁺) and bone marrow mononucleated cell antibodies (BMMNC-Ab) were determined via fluorescence-activated cell sorting, and clinical outcomes of these patients were analyzed.
Results:
(1)43 initial patients achieved obvious remission in all 52 initial cases after conventional immunosuppression therapy. 16 relapsed patients with IRP received Rituximab (RTX) and 14 cases achieved obvious remission, among which 7 cases were refractory to conventional immunosuppression therapy, 5 cases exhibited obvious remission, and 2 cases did not respond. Other 18 relapsed cases received conventional immunosuppression therapy and 13 cases achieved obvious remission. (1)The level of Bm in PB in 52 initial patients with IRP was(1.81 ± 0.97)%, and no significant difference was observed between the initial patients and health volunteers (1.75 ± 0.55)% (P>0.05). The level of Bm in PB in 34 relapsed patients with IRP was obviously higher than that in the initial IRP patients and health volunteers (P<0.05). Significant difference was observed in the level of Bm in PB in 16 relapsed IRP patients between pre-therapy and post-therapy with RTX (P<0.05). No statistical difference was found between the remission and no-response groups in relapsed patients treated with RTX. RTX regimen produced more effective outcome than conventional immunosuppression therapy, which better eliminated Bm than the latter (P<0.05). Initial patients with IRP who relapsed within a two-year follow-up period had a lower level of Bm in PB compared with un-relapsed patients (P<0.05). Majority of BMMNC- Ab antibodies in relapsed patients were IgG (82.4%) and IgM (69.2%) autoantibodies in patients with initial IRP.
Conclusion:
The level of Bm in PB was associated with relapsed patients with IRP. Bm did not respond to conventional immunosuppression therapy,but responded to RTX.
