Quantitative and qualitative investigation of lymphocytes in pediatric acute lymphoblastic leukemia using flow cytometry

Abstract

Acute lymphoblastic leukemia is the most prevalent pediatric malignant neoplasm. Despite improved survival over the last two decades, the adverse effects of current treatments, such as graft-versus-host disease and cytokine release syndrome, necessitate the search for safer therapies. Recent studies demonstrated that novel anti-leukemic treatment based on double-negative T (DNT) lymphocytes might address safety concerns. However, there is insufficient fundamental quantitative data on endogenous double-negative T cells, especially in children. This study aims to analyze the number and immunophenotypic markers of lymphocytes in 54 children with acute lymphoblastic leukemia, with a specific focus on CD3+CD4-CD8- T (DNT) cells to investigate if there are any specific or unspecific abnormalities, which may even correlate with disease activity or inflammatory parameters using flow cytometry. 46 healthy age and gender-matched controls were enrolled as well. The hematological data were retrieved from the clinical files, as secondary existing data. Total DNT cell count was decreased in patients with ALL (2.9%) compared to healthy controls (4.8%; p < 0.0001). Subset analysis showed mild elevation of αβ+ DNT cells (0.76% in ALL vs 0.57% in controls; p=0.2572) and reduction in γδ+ DNT cells (1.56% in ALL vs 3.26% in controls; p<0.0001).