Экспрессия LAG-3 на В-лимфоцитах как маркер прогноза ответа на терапию у больных хроническим лимфолейкозом

Цель исследования ‒ изучить уровень экспрессии LAG-3 на В-лимфоцитах и возможность его применения в качестве маркера прогноза ответа на терапию у больных хроническим лимфолейкозом (ХЛЛ).

Материал и методы. В исследование включены 40 больных с впервые установленным диагнозом ХЛЛ. Пациенты были разделены на две группы: I – ХЛЛ стадии A по Binet, которым не требовалось проведение терапии, II – ХЛЛ стадии С, которым проводилась иммунохимиотерапия в режимах RB и FCR. В зависимости от схемы лечения и гематологического ответа больных на терапию выделены 4 подгруппы: IIА-RB, IIА-FCR, IIБ-RB, IIБ-FCR. В контрольную группу, сопоставимую по возрасту и полу, вошли 20 человек без злокачественных заболеваний. Исходно во всех группах методом проточной цитофлюориметрии определены иммунофенотип и уровень В-лимфоцитов, экспрессия LAG-3, а также минимальная остаточная болезнь в группе II после 6-го курса иммунохимиотерапии. Данные оценены в программе Statistica 13.0.

Результаты. Во всех группах больных ХЛЛ до лечения обнаружена экспрессия LAG-3 на В-лимфоцитах в отличие от контрольной группы. Более высокий уровень экспрессии отмечен у больных ХЛЛ стадии С по Binet по сравнению с пациентами с ХЛЛ стадии А. Данные демонстрируют отличия в уровне экспрессии LAG-3 у больных с разным ответом на проводимую терапию. Так, исходно более высокий уровень экспрессии LAG-3 на В-лимфоцитах наблюдается у больных ХЛЛ стадии С по Binet с неудовлетворительным ответом на терапию. Установлено, что при уровне экспрессии LAG-3 на В-лимфоцитах в пределах 14,57 ± 0,66 % можно предполагать хороший гематологический ответ независимо от схемы проводимой терапии, а при значениях 41,95 ± 1,62 % – неудовлетворительный ответ на лечение.

Заключение. Исходный уровень экспрессии LAG-3 на B-лимфоцитах у больных хроническим лимфолейкозом может быть использован в качестве маркера для прогнозирования и мониторинга ответа на лечение независимо от используемого режима иммунохимиотерапии.

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