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Blood, 1 August 2007, Vol. 110, No. 3, pp. 847-850.
Prepublished online as a Blood First Edition Paper on April 5, 2007; DOI 10.1182/blood-2007-01-067546.


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CLINICAL TRIALS AND OBSERVATIONS

Brief Report

CD4+CD25high Foxp3+ regulatory T cells in myelodysplastic syndrome (MDS)

Shahram Y. Kordasti1, Wendy Ingram1, Janet Hayden1, David Darling1, Linda Barber1, Behdad Afzali2, Giovanna Lombardi2, Marcin W. Wlodarski3, Jaroslaw P. Maciejewski3, Farzin Farzaneh1, and Ghulam J. Mufti1

1 Department of Hematological Medicine, King's College London, London, United Kingdom; 2 Immunoregulation Laboratory, Department of Nephrology and Transplantation, King's College London, London, United Kingdom; 3 Experimental Hematology and Hematopoiesis Section, Cleveland Clinic Foundation, Cleveland, OH.

Foxp3+ regulatory T cells (Tregs) play a central role in maintaining immune tolerance. A reduction in the function of Tregs is a key feature of autoimmune diseases, whereas their expansion in malignant diseases leads to the suppression of host antitumor responses. We analyzed the absolute number of CD4+ and CD8+ Tregs in the peripheral blood of 52 patients with myelodysplastic syndrome (MDS) and show a significant correlation between increased number of CD4+ Tregs and MDS subgroups with 5% or more bone marrow blasts (P < .001), high International Prognostic Scoring System (IPSS) score (P < .001), and disease progression (P < .001), whereas no correlation between CD8+ Tregs and prognostic variables was observed. The CD4+ Tregs showed a polyclonal spectratype, and the percentage of the naive subset was significantly higher in the high-risk patients compared with low-risk or healthy age-matched donors (P = .032). Our data suggest that CD4+ Treg expansion is a feature of high-risk MDS and progression to aggressive subtypes of the disease.


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