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Cited by 2 publications
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Subsets of natural killer cells in chronic myeloid leukemia and their relation with some inflammatory cytokines
BACKGROUND: As in other malignancies, different subsets of natural killer (NK) cells play a crucial role in the recognition and lysing of malignant cells in chronic myeloid leukemia (CML). OBJECTIVES: This study aims to identify two subsets of NK, cytotoxic (cluster of differentiation [CD] 16+bright) and cytokine-producing NK (CD56+bright) in newly diagnosed CML patients. MATERIALS AND METHODS: This study is conducted on 20 newly diagnosed Iraqi patients (12 males and 8 females) with CML, in chronic phase, at the age range of 17–55 years. Along with patients, 20 healthy subjects (with matched age and gender) were enrolled to act as a control group. To identify NK cells and their subsets in peripheral blood samples, the expression of CD45, CD3, CD56, and CD16 markers was evaluated by flow cytometry technique. Furthermore, the serum level of interferon gamma (IFN-γ) and interleukin (IL)-18 was determined by the enzyme-linked immunosorbent assay technique. RESULTS: The age of patients at the diagnosis of disease is (35.6 ± 12.2 years) and the male: female ratio was 1.5:1. The serum level of IL-18 in newly diagnosed CML patients (30.3 ± 6.5 pg/mL) was significantly (P < 0.0001) higher than those in control group (18.3 ± 7.8 pg/mL), while the serum levels of IFN-γ in newly diagnosed patients are significantly (P = 0.006) dropped down to (89.1 ± 7.2 pg/mL from that in control group (109.4 ± 30.3 pg/mL). The percentage of NK cells in newly diagnosed CML patients is significantly lower than in control group. There is a significant elevation in the cytotoxic NK cells (CD16+bright) subset, and a significant decrease in the cytokine-producing NK subset (CD56+bright) in newly diagnosed patients when compared to those in control group. CONCLUSION: Although there is an elevation in the percentage of cytotoxic NK cells (CD16+bright) subset of CML patients at the first diagnosis, these cells are not able to recognize and attack malignant cells, which may be due to low expression of their activating receptors and needs more investigation. Furthermore, present results found a low percentage of cytokine-producing NK cells (CD56+bright) and a low level of IFN-γ in CML patients, although there is an elevation in IL-18, which indicates that IL-18 may be not the main stimulator to these cells, so activation pathway of this subset of NK cells needs further investigation.
Subsets of natural killer cells in chronic myeloid leukemia and their relation with some inflammatory cytokines
BACKGROUND: As in other malignancies, different subsets of natural killer (NK) cells play a crucial role in the recognition and lysing of malignant cells in chronic myeloid leukemia (CML). OBJECTIVES: This study aims to identify two subsets of NK, cytotoxic (cluster of differentiation [CD] 16+bright) and cytokine-producing NK (CD56+bright) in newly diagnosed CML patients. MATERIALS AND METHODS: This study is conducted on 20 newly diagnosed Iraqi patients (12 males and 8 females) with CML, in chronic phase, at the age range of 17–55 years. Along with patients, 20 healthy subjects (with matched age and gender) were enrolled to act as a control group. To identify NK cells and their subsets in peripheral blood samples, the expression of CD45, CD3, CD56, and CD16 markers was evaluated by flow cytometry technique. Furthermore, the serum level of interferon gamma (IFN-γ) and interleukin (IL)-18 was determined by the enzyme-linked immunosorbent assay technique. RESULTS: The age of patients at the diagnosis of disease is (35.6 ± 12.2 years) and the male: female ratio was 1.5:1. The serum level of IL-18 in newly diagnosed CML patients (30.3 ± 6.5 pg/mL) was significantly (P < 0.0001) higher than those in control group (18.3 ± 7.8 pg/mL), while the serum levels of IFN-γ in newly diagnosed patients are significantly (P = 0.006) dropped down to (89.1 ± 7.2 pg/mL from that in control group (109.4 ± 30.3 pg/mL). The percentage of NK cells in newly diagnosed CML patients is significantly lower than in control group. There is a significant elevation in the cytotoxic NK cells (CD16+bright) subset, and a significant decrease in the cytokine-producing NK subset (CD56+bright) in newly diagnosed patients when compared to those in control group. CONCLUSION: Although there is an elevation in the percentage of cytotoxic NK cells (CD16+bright) subset of CML patients at the first diagnosis, these cells are not able to recognize and attack malignant cells, which may be due to low expression of their activating receptors and needs more investigation. Furthermore, present results found a low percentage of cytokine-producing NK cells (CD56+bright) and a low level of IFN-γ in CML patients, although there is an elevation in IL-18, which indicates that IL-18 may be not the main stimulator to these cells, so activation pathway of this subset of NK cells needs further investigation.
Some Hematological Indices as Predictors of Survival in Chronic Myeloid Leukemia Patients
Background: Despite the promising of introduction of tyrosine kinase inhibitors (TKIs), chronic myeloid leukemia (CML) remains a significant cause of annual mortality. Red blood cell distribution width (RDW), neutrophil/lymphocyte ratio (NLR), and platelet/lymphocyte ratio (PLR) are parameters derived from a complete blood count (CBC) commonly used to diagnose anemia, autoimmune diseases, and inflammation. These parameters have been reported to have a strong association with various diseases, including hematologic malignancies. Objectives: The study aims to identify whether RDW, NLR, and PLR can act as predictors of survival in newly diagnosed and treated CML patients. Materials and Methods: The study involved 60 Iraqi patients (37 males, 23 females, aged 17–69 years) with CML at chronic phase, who were referred to the National Center of Hematology/Mustansiriyah University, Baghdad, from February 2022 to December 2022. Twenty were newly diagnosed (T0), and 40 were under TKI treatment (T+), with 20 on imatinib and 20 on nilotinib. Additionally, a control group of 20 age- and gender-matched healthy subjects was included. CBC assessed red blood cell (RBC) indices across all groups. Results: There was no significant difference in the age of CML patients at the onset of disease between males (34.5 ± 11.7 years) and females (34 ± 11.9 years). Likewise, there was no significant difference in the treatment of CML patients with imatinib or nilotinib between males (48% and 52%) and females (53.3% and 47.7%), respectively. Most RBC indices for patients and controls were within normal ranges without significant differences. However, RDW% in T0 was markedly elevated (20.4%), with about 80% showing anisocytosis, surpassing both T+ and controls, and exceeding the upper limit of normal. The total and differential white blood cell (WBC) counts were significantly higher in T0 compared to T+, exceeding their normal ranges. Additionally, the NLR was significantly higher in T0 (8.13) compared with T+ and controls (1.80 and 1.87, respectively). Platelet count, mean platelet volume, and platelet distribution width (PDW%) differed significantly among the three groups but remained within the normal range. However, PLR in T0 (31 ± 24) was significantly lower than those in T+ and controls (130 ± 43 and 102 ± 27, respectively). Conclusion: It can be concluded that the monitoring of some parameters in peripheral blood in CBC test (as a simple and inexpensive test) such as RDW%, NLR%, and PLR% during the therapy course of CML patients may act as predictive markers to evaluate the prognosis of disease in CML patients and the degree of response to certain TKI treatment.
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