Kronik Lenfositik Lösemide PD-1/PDL1 Ekspresyon Düzeyleri ve Prognostik Önemi

Amaç: Çalışmamızda, kronik lenfositik lösemide (KLL) programlı hücre ölümü 1 (PD-1) ve programlı hücre ölümü ligandı 1 (PD-L1) ekspresyon düzeylerinin belirlenmesi ve prognoz üzerine etkilerinin değerlendirilmesi amaçlandı. Hastalar ve yöntemler: Kliniğimizde takip edilmiş ve tanı anında periferik kandan akım sitometrisi çalışılmış 92 hasta bu çalışmaya dahil edildi. Lenfositlerde %20 ve üzeri hücrede PD-1/PD-L1 boyanma varlığı pozitif olarak kabul edildi. Bulgular: Hastaların ortanca takip süresi 31 (1-114) aydı. PD-1 pozitifliği hastaların 44’ünde (%47.8), PD-L1 pozitifliği ise 8’inde (%8.7) tespit edildi. Tüm kohortta ortalama PD-1 düzeyi %22.13±15.39, PD-L1 düzeyi ise %8.4±13.12 olarak saptandı. Ortanca genel sağkalıma ulaşılamamış olmakla birlikte 60. ayda PD-1 pozitif hastaların %69.1’i hayattayken, PD-1 negatif grupta bu oran %79’du (p=0.723). Yine 60. ayda PD-L1 pozitif hastaların %75’i hayattayken, PD-L1 negatif grupta bu oran %73.6’ydı (p=0.849). PD-1 negatif grupta ilk dizi tedavi sonrası kısmi yanıt ve üstü 18 (%85.7) hastada mevcutken, PD-1 pozitif grupta 10 (%71.4) hastada mevcuttu (p=0.401). Ortanca progresyonsuz sağkalım, PD-1 pozitif grupta 16 ay [ %95 GA,10.68-21.31] iken PD-1 negatif grupta 18 ay [%95 GA, 5.23-30.76] olarak tespit edildi (p=0.432). PD-1 pozitif hastalarda ikinci dizi tedaviye geçiş süresi 2 (0-25) ay iken, PD-1 negatif hastalarda 7 (0-80) ay olarak tespit edildi (p=0.372). Sonuç: KLL’de periferik kanda lenfositler üzerinde PD-1 ekspresyonu tespit edilmiş olup PD-L1 ekspresyon düzeyi oldukça düşük düzeyde saptandı. PD-1 ve PD-L1 pozitifliğinin prognoz üzerinde net bir etkisi gözlemlenmedi.Anahtar kelimeler: programlı hücre ölümü 1, programlı hücre ölümü ligandı 1, kronik lenfositik lösemi

Anahtar Kelime:

PD-1/PD-L1 Expression Levels and Prognostic Significance in Chronic Lymphocytic Leukemia

Öz:

Objectives: In this study, we aimed to evaluate expression levels of programmed cell death 1 (PD-1) and programmed cell death ligand 1 (PD-L1) and the effects on prognosis in chronic lymphocytic leukemia (CLL). Patients and Methods: 92 patients who had flow cytometry from peripheral blood at the time of diagnosis were included in this study. The presence of PD-1/PD-L1 staining in 20% and above in lymphocytes was considered positive. Results: The median follow-up was 31 (1-114) months. PD-1 positivity was detected in 44 (47.8%), and PD-L1 positivity in 8 (8.7%) patients. The mean PD-1 level was 22.13% ± 15.39, and PD-L1 level was 8.4% ± 13.12 in all cohort. Overall survival rates were 69.1% in PD-1+ vs 79% in PD-1-groups and 75% in PD-L1+ vs 73.6% in the PD-L1-group in the 60th month (p=0.723, p=0.849 respectively). After first line treatment, partial response or better was observed in 18 (85.7%) patients in the PD-1-group and in 10 (71.4%) patients in the PD-1+ group (p=0.401). The median progression-free survival was 16 months [95% CI, 10.68-21.31] in the PD-1+ group, and 18 months [95% CI, 5.23-30.76] in the PD-1-group (p=0.432). In PD-1+ patients, time to next treatment was 2 (0-25) months, while in PD-1-patients it was determined as 7 (0-80) months (p=0.372). Conclusion: PD-1 expression was detected on lymphocytes in peripheral blood in CLL; however, the PD-L1 expression level was quite low. There was no clear effect of PD-1 and PD-L1 positivity on prognosis.Keywords: programmed cell death 1, programmed cell death ligand 1, chronic lymphocytic leukemia

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	gedük a, Mehtap Ö, Birtas Atesoglu E, Tarkun P, Terzi Demirsoy E, Uluköylü Mengüç M, Ünal S, Mersin S, Hacıhanefioğlu A, Burhanoğlu T, GACAR G (2021). Kronik Lenfositik Lösemide PD-1/PDL1 Ekspresyon Düzeyleri ve Prognostik Önemi. , 197 - 203. 10.31067/acusaglik.850893
Chicago	gedük ayfer,Mehtap Özgür,Birtas Atesoglu Elif,Tarkun Pinar,Terzi Demirsoy Esra,Uluköylü Mengüç Meral,Ünal Serkan,Mersin Sinan,Hacıhanefioğlu Abdullah,Burhanoğlu Tülin,GACAR GÜLÇİN Kronik Lenfositik Lösemide PD-1/PDL1 Ekspresyon Düzeyleri ve Prognostik Önemi. (2021): 197 - 203. 10.31067/acusaglik.850893
MLA	gedük ayfer,Mehtap Özgür,Birtas Atesoglu Elif,Tarkun Pinar,Terzi Demirsoy Esra,Uluköylü Mengüç Meral,Ünal Serkan,Mersin Sinan,Hacıhanefioğlu Abdullah,Burhanoğlu Tülin,GACAR GÜLÇİN Kronik Lenfositik Lösemide PD-1/PDL1 Ekspresyon Düzeyleri ve Prognostik Önemi. , 2021, ss.197 - 203. 10.31067/acusaglik.850893
AMA	gedük a,Mehtap Ö,Birtas Atesoglu E,Tarkun P,Terzi Demirsoy E,Uluköylü Mengüç M,Ünal S,Mersin S,Hacıhanefioğlu A,Burhanoğlu T,GACAR G Kronik Lenfositik Lösemide PD-1/PDL1 Ekspresyon Düzeyleri ve Prognostik Önemi. . 2021; 197 - 203. 10.31067/acusaglik.850893
Vancouver	gedük a,Mehtap Ö,Birtas Atesoglu E,Tarkun P,Terzi Demirsoy E,Uluköylü Mengüç M,Ünal S,Mersin S,Hacıhanefioğlu A,Burhanoğlu T,GACAR G Kronik Lenfositik Lösemide PD-1/PDL1 Ekspresyon Düzeyleri ve Prognostik Önemi. . 2021; 197 - 203. 10.31067/acusaglik.850893
IEEE	gedük a,Mehtap Ö,Birtas Atesoglu E,Tarkun P,Terzi Demirsoy E,Uluköylü Mengüç M,Ünal S,Mersin S,Hacıhanefioğlu A,Burhanoğlu T,GACAR G "Kronik Lenfositik Lösemide PD-1/PDL1 Ekspresyon Düzeyleri ve Prognostik Önemi." , ss.197 - 203, 2021. 10.31067/acusaglik.850893
ISNAD	gedük, ayfer vd. "Kronik Lenfositik Lösemide PD-1/PDL1 Ekspresyon Düzeyleri ve Prognostik Önemi". (2021), 197-203. https://doi.org/10.31067/acusaglik.850893

APA	gedük a, Mehtap Ö, Birtas Atesoglu E, Tarkun P, Terzi Demirsoy E, Uluköylü Mengüç M, Ünal S, Mersin S, Hacıhanefioğlu A, Burhanoğlu T, GACAR G (2021). Kronik Lenfositik Lösemide PD-1/PDL1 Ekspresyon Düzeyleri ve Prognostik Önemi. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, 12(2), 197 - 203. 10.31067/acusaglik.850893
Chicago	gedük ayfer,Mehtap Özgür,Birtas Atesoglu Elif,Tarkun Pinar,Terzi Demirsoy Esra,Uluköylü Mengüç Meral,Ünal Serkan,Mersin Sinan,Hacıhanefioğlu Abdullah,Burhanoğlu Tülin,GACAR GÜLÇİN Kronik Lenfositik Lösemide PD-1/PDL1 Ekspresyon Düzeyleri ve Prognostik Önemi. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 12, no.2 (2021): 197 - 203. 10.31067/acusaglik.850893
MLA	gedük ayfer,Mehtap Özgür,Birtas Atesoglu Elif,Tarkun Pinar,Terzi Demirsoy Esra,Uluköylü Mengüç Meral,Ünal Serkan,Mersin Sinan,Hacıhanefioğlu Abdullah,Burhanoğlu Tülin,GACAR GÜLÇİN Kronik Lenfositik Lösemide PD-1/PDL1 Ekspresyon Düzeyleri ve Prognostik Önemi. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, vol.12, no.2, 2021, ss.197 - 203. 10.31067/acusaglik.850893
AMA	gedük a,Mehtap Ö,Birtas Atesoglu E,Tarkun P,Terzi Demirsoy E,Uluköylü Mengüç M,Ünal S,Mersin S,Hacıhanefioğlu A,Burhanoğlu T,GACAR G Kronik Lenfositik Lösemide PD-1/PDL1 Ekspresyon Düzeyleri ve Prognostik Önemi. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi. 2021; 12(2): 197 - 203. 10.31067/acusaglik.850893
Vancouver	gedük a,Mehtap Ö,Birtas Atesoglu E,Tarkun P,Terzi Demirsoy E,Uluköylü Mengüç M,Ünal S,Mersin S,Hacıhanefioğlu A,Burhanoğlu T,GACAR G Kronik Lenfositik Lösemide PD-1/PDL1 Ekspresyon Düzeyleri ve Prognostik Önemi. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi. 2021; 12(2): 197 - 203. 10.31067/acusaglik.850893
IEEE	gedük a,Mehtap Ö,Birtas Atesoglu E,Tarkun P,Terzi Demirsoy E,Uluköylü Mengüç M,Ünal S,Mersin S,Hacıhanefioğlu A,Burhanoğlu T,GACAR G "Kronik Lenfositik Lösemide PD-1/PDL1 Ekspresyon Düzeyleri ve Prognostik Önemi." Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, 12, ss.197 - 203, 2021. 10.31067/acusaglik.850893
ISNAD	gedük, ayfer vd. "Kronik Lenfositik Lösemide PD-1/PDL1 Ekspresyon Düzeyleri ve Prognostik Önemi". Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 12/2 (2021), 197-203. https://doi.org/10.31067/acusaglik.850893