title: Immune monitoring using the predictive power of immune profiles.
abstract: BACKGROUND
  We have developed a novel approach to categorize immunity in patients that uses a combination of whole blood flow cytometry and hierarchical clustering.
  
  
  METHODS
  Our approach was based on determining the number (cells/μl) of the major leukocyte subsets in unfractionated, whole blood using quantitative flow cytometry. These measurements were performed in 40 healthy volunteers and 120 patients with glioblastoma, renal cell carcinoma, non-Hodgkin lymphoma, ovarian cancer or acute lung injury. After normalization, we used unsupervised hierarchical clustering to sort individuals by similarity into discreet groups we call immune profiles.
  
  
  RESULTS
  Five immune profiles were identified. Four of the diseases tested had patients distributed across at least four of the profiles. Cancer patients found in immune profiles dominated by healthy volunteers showed improved survival (p < 0.01). Clustering objectively identified relationships between immune markers. We found a positive correlation between the number of granulocytes and immunosuppressive CD14(+)HLA-DR(lo/neg) monocytes and no correlation between CD14(+)HLA-DR(lo/neg) monocytes and Lin(-)CD33(+)HLA-DR(-) myeloid derived suppressor cells. Clustering analysis identified a potential biomarker predictive of survival across cancer types consisting of the ratio of CD4(+) T cells/μl to CD14(+)HLA-DR(lo/neg) monocytes/μL of blood.
  
  
  CONCLUSIONS
  Comprehensive multi-factorial immune analysis resulting in immune profiles were prognostic, uncovered relationships among immune markers and identified a potential biomarker for the prognosis of cancer. Immune profiles may be useful to streamline evaluation of immune modulating therapies and continue to identify immune based biomarkers.
authors.affiliation: Human Cellular Therapy Laboratory, Division of Transfusion Medicine, Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street, Rochester, MN, USA.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Gustafson
authors.affiliation: Division of Hematology, Department of Medicine, Mayo Clinic, 200 First Street, Rochester, MN, USA.
authors.forename: Yi
authors.initials: Y
authors.lastname: Lin
authors.affiliation: Biomedical Statistics and Informatics, Mayo Clinic, 200 First Street, Rochester, MN, USA.
authors.forename: Betsy
authors.initials: B
authors.lastname: LaPlant
authors.affiliation: Human Cellular Therapy Laboratory, Division of Transfusion Medicine, Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street, Rochester, MN, USA.
authors.forename: Courtney J
authors.initials: CJ
authors.lastname: Liwski
authors.affiliation: Human Cellular Therapy Laboratory, Division of Transfusion Medicine, Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street, Rochester, MN, USA.
authors.forename: Mary L
authors.initials: ML
authors.lastname: Maas
authors.affiliation: Cellular and Molecular Immunology, Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street, Rochester, MN, USA.
authors.forename: Stacy C
authors.initials: SC
authors.lastname: League
authors.affiliation: Pulmonary and Critical Care Medicine, Mayo Clinic, 200 First Street, Rochester, MN, USA.
authors.forename: Philippe R
authors.initials: PR
authors.lastname: Bauer
authors.affiliation: Cellular and Molecular Immunology, Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street, Rochester, MN, USA.
authors.forename: Roshini S
authors.initials: RS
authors.lastname: Abraham
authors.affiliation: Department of Urology, Mayo Clinic, 200 First Street, Rochester, MN, USA.
authors.forename: Matthew K
authors.initials: MK
authors.lastname: Tollefson
authors.affiliation: Department of Urology, Mayo Clinic, 200 First Street, Rochester, MN, USA.
authors.forename: Eugene D
authors.initials: ED
authors.lastname: Kwon
authors.affiliation: Human Cellular Therapy Laboratory, Division of Transfusion Medicine, Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street, Rochester, MN, USA ; Division of Hematology, Department of Medicine, Mayo Clinic, 200 First Street, Rochester, MN, USA.
authors.forename: Dennis A
authors.initials: DA
authors.lastname: Gastineau
authors.affiliation: Human Cellular Therapy Laboratory, Division of Transfusion Medicine, Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street, Rochester, MN, USA.
authors.forename: Allan B
authors.initials: AB
authors.lastname: Dietz
keywords: Biomarker; CD14; CD4; Cancer; Human; Immunity; Monocytes; Myeloid suppressor; Survival; Treg