文章：

多发性骨髓瘤的长期生存与独特的免疫特征有关，包括增殖的细胞毒性t细胞克隆和有利的Treg/Th17平衡

Long-term survival in multiple myeloma is associated with a distinct immunological profile, which includes proliferative cytotoxic T-cell clones and a favourable Treg/Th17 balance

原文发布日期：2013-09-13

DOI: 10.1038/bcj.2013.34

类型: Original Article

开放获取: 是

英文摘要：

Despite improved outcomes in multiple myeloma (MM), a cure remains elusive. However, even before the current therapeutic era, 5% of patients survived >10 years and we propose that immune factors contribute to this longer survival. We identified patients attending our clinic, who had survived >10 years (n=20) and analysed their blood for the presence of T-cell clones, T-regulatory cells (Tregs) and T helper 17 (Th17) cells. These results were compared with MM patients with shorter follow-up and age-matched healthy control donors. The frequency of cytotoxic T-cell clonal expansions in patients with <10 years follow-up (MM patients) was 54% (n=144), whereas it was 100% (n=19/19) in the long-survivors (LTS-MM). T-cell clones from MM patients proliferated poorly in vitro, whereas those from LTS-MM patients proliferated readily (median proliferations 6.1% and 61.5%, respectively (P<0.0001)). In addition, we found significantly higher Th17 cells and lower Tregs in the LTS-MM group when compared with the MM group. These results indicate that long-term survival in MM is associated with a distinct immunological profile, which is consistent with decreased immune suppression.

摘要翻译： 

尽管多发性骨髓瘤（MM）的治疗结果有所改善，但治愈仍难以实现。不过，即便在当前治疗时代之前，仍有5%的患者生存期超过10年，我们认为免疫因素促成了这种长期生存。我们选取了门诊中生存超过10年的患者（n=20），分析其血液中T细胞克隆、调节性T细胞（Tregs）和辅助性T17（Th17）细胞的存在情况，并将这些结果与随访时间较短的MM患者及年龄匹配的健康供者进行对比。随访不足10年的MM患者中细胞毒性T细胞克隆扩增频率为54%（n=144），而长期生存者（LTS-MM）中这一比例达到100%（19/19）。MM患者的T细胞克隆在体外增殖能力较弱，而LTS-MM患者的T细胞克隆则易于增殖（中位增殖率分别为6.1%和61.5%，P<0.0001）。此外，与MM组相比，LTS-MM组的Th17细胞显著更高，Tregs显著更低。这些结果表明，MM的长期生存与独特的免疫特征相关，其特征与免疫抑制减弱相一致。

原文链接：

Long-term survival in multiple myeloma is associated with a distinct immunological profile, which includes proliferative cytotoxic T-cell clones and a favourable Treg/Th17 balance