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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.
CLINICAL TRIALS AND OBSERVATIONS CD4+CD25high Foxp3+ regulatory T cells in myelodysplastic syndrome (MDS)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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