title: Prognostic significance of CD8 and CD4 T cells in chronic lymphocytic leukemia.
abstract: The prognostic value of the number of T cells and NK cells at diagnosis in CLL was analyzed in a cohort of 256 patients with CLL diagnosed between 1997 and 2007. Patients with leukemia showed elevated NK cells and T cell populations and CD4/CD8 ratio was inverted in 39.7% cases. Prognostic significance of lymphocytes was analyzed as a ratio of relative number of T cells to the size of the malignant monoclonal B-cell pool (T/NK cells:Malignant monoclonal B-cells ratio). Patients showed higher relative number of CD4 (p = 0.03), CD8 (p = 0.02), and NK cells (p = 0.01) in early Rai stage of disease. The multivariate Cox analysis identified the relative number of CD8 (hazard ratio (HR) = 1.464; p = 0.006) and CD4 T cells (HR = 0.091; p < 0.01) as independent predictors for survival. Additionally, patients with relative CD8 count > 0.074 or CD4 count > 0.1 had higher 10-year overall survival than patients with CD8 count  ≤0.074 or CD4 count  ≤0.1 (p = 0.002). Higher CD8 count was associated with significantly higher median time of survival of patients (149.33 vs. 82.06 months). Finally, association of the good prognostic factor of leukemia cells (CD38⁻ with high relative CD8 count identified a group of patients with an indolent clinical course with an overall survival probability at 10 years of 95%.
authors.affiliation: Hematology Department, Hospital Cabue&#x00F1;es, Cabue&#x00F1;es sn, Gij&#x00F3;n, Spain.
authors.forename: Ana P
authors.initials: AP
authors.lastname: Gonzalez-Rodriguez
authors.forename: Juan
authors.initials: J
authors.lastname: Contesti
authors.forename: Leticia
authors.initials: L
authors.lastname: Huergo-Zapico
authors.forename: Alejandro
authors.initials: A
authors.lastname: Lopez-Soto
authors.forename: Azahara
authors.initials: A
authors.lastname: Fernández-Guizán
authors.forename: Andrea
authors.initials: A
authors.lastname: Acebes-Huerta
authors.forename: Ana J
authors.initials: AJ
authors.lastname: Gonzalez-Huerta
authors.forename: Esther
authors.initials: E
authors.lastname: Gonzalez
authors.forename: Carmen
authors.initials: C
authors.lastname: Fernandez-Alvarez
authors.forename: Segundo
authors.initials: S
authors.lastname: Gonzalez
mesh_terms: D000368:Aged; D015496:CD4-Positive T-Lymphocytes / Q000473:pathology*; D018414:CD8-Positive T-Lymphocytes / Q000473:pathology*; D005260:Female; D005434:Flow Cytometry / Q000706:statistics & numerical data; D006801:Humans; D053208:Kaplan-Meier Estimate; D007694:Killer Cells, Natural / Q000473:pathology*; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000473:pathology* / Q000628:therapy; D018655:Lymphocyte Count; D008297:Male; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D013997:Time Factors