CD4:CD8 ratio prognostic impact in patients with chronic lymphocytic leukemia

Author: 
Nidhi kaushik, Monika gupta, Sakshi dahiya, Rajeev sen and Sunita singh

Background: Chronic lymphocytic leukemia (CLL) is a lymphoproliferative disease characterized by clonal expansion of B- cells. The clinical course of B-CLL patients is highly variable. Immunosuppression is a prevalent clinical feature in chronic lymphocytic leukemia (CLL) patients. To provide further clarity to this particular phenomenon, we analyzed the T-cell pro le of CLL patient samples within a large cohort and observed that patients with an inverted CD4/CD8 ratio had a shorter time to treatment as well as overall survival. Material and methods: This study was conducted over a period of one year on 50 newly diagnosed cases of CLL and 20 control samples from apparently healthy individuals at PGIMS Rohtak. 2 ml EDTA peripheral blood immunophenotyping was performed on 8 Color Flow cytometer BD FACS Canto II (Becton Dickinson, San Jose, CA). The CD panel used CD45, CD19, CD20, CD23, CD5, CD200, CD38, CD4, CD8, CD3, FMC7, CD10, CD79b, Kappa, Lambda. Results: There was slight male predominance with male to female ratio of 1.6:1 in our study. Average age of the patients was 60.8 years (range 43-85 years).  The mean helper to suppressor ratio (CD4/CD8) of 50 patients with CLL was 1.2±0.28 as compared to the mean of 20 normal volunteers tested at the same period of time was 1.86 ± 0.64 (p < 0.00). The low CD4/CD8 ratio found in advanced stages is due to a decrease of the absolute number of CD4 + cells. Conclusions: The finding of the present study which is probably of clinical relevance is the fact that immune function parameter at diagnosis seem to have predictive value in patient with CLL in clinical stage III and IV. CD4/CD8 ratio was decreased in advanced form of chronic lymphocytic leukemia and this simple parameter of immune function seem to have a huge prognostic value for patients with CLL and predict the clinical course of the disease.

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DOI: 
http://dx.doi.org/10.24327/ijcar.2022.1722.0385
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