Study on the difference of fine immune indexes of different conditioning regimens in microtransplantation for acute myeloid leukemia

ZHENG Han-xue; ZHANG Lian-sheng; LI Li-juan

doi:10.19538/j.nk2025010108

Abstract：Objective The objective of this study was to investigate different pretreatment schemes for micro-transplantation(MST)in the treatment of acute myeloid leukemia(AML),aiming to explore the potential immune mechanisms underlying effective MST and identify optimized pretreatment strategies.Methods A total of 61 AML patients who underwent MST treatment at the Second Hospital of Lanzhou University from August 2015 to April 2024 were included,along with 14 AML patients who received maintenance therapy without MST.The MST patients were divided into venetoclax conditioning regimen group and non-venetoclax conditioning regimen group,and the patients who did not receive MST were served as control group.Flow cytometry and cytometric bead array(CBA)were used to detect a total of 19 immune indexes.Differences among the three groups,changes in fine immune indexes before and after treatment,and correlations between lymphocyte subsets and cytokines were observed.Kaplan-Meier survival analysis was performed among the three groups.Results Patients treated withmicrotransplantationhad better PFS and OS(P＜0.05).A total of 9 meaningful immune markers were found to be associated with MST,specifically in venetoclax group,total T cell and B cell percentages increased,while CD4+T cell percentage,IFN-γ,and IL-12p70 decreased(P＜0.05).In non-venetoclax group,total B cell percentage increased,while total T cell,CD4+T cell,CD4+/CD8+,IL-4,TNF-α,and IL-17A percentages decreased(P＜0.05).Conclusion Venetoclax pret-reatment regimendemonstrated more favorable changes in immune indexes and better clinical outcomes,which is worthy of further research and application.