| Abstract | Cilj istraživanja: Prikazivanje i usporedba imunofenotipizacije T-limfocita, B-limfocita i NK
stanica prije primjene prve i prije primjene druge doze okrelizumaba u bolesnika oboljelih od
MS-e u KBC-u Split od 1. siječnja 2019. do 31. prosinca 2021. godine.
Ispitanici i postupci: Uključeno je 22 pacijenata oboljelih od MS-e starijih od 18 godina koji
su se liječili okrelizumabom u Klinici za neurologiju KBC-a Split u navedenom trogodišnjem
razdoblju. Analizirani su podatci o spolu, dobi, tipu MS-e i prosječnom trajanju bolesti od
dijagnoze MS-e do prvog primanja okrelizumaba. Uspoređeni su laboratorijski nalazi
prikupljeni do 2 dana prije prve infuzije prve doze i mjesec dana nakon primjene druge infuzije
prve doze okrelizumaba te imunofenotipizacije stanica i elektroforeze proteina prije prve i prije
druge doze okrelizumaba. Statistička značajnost postavljena je na P<0,05.
Rezultati: Od ukupno 22 ispitanika, 15 je ženskog (68,2%), a 7 muškog spola (31,8%). Medijan
dobi iznosio je 46,5 u rasponu od 37,5 do 53,25 godina. Prosječno trajanje bolesti od dijagnoze
MS-e do prve primjene okrelizumaba kod bolesnika s RRMS-om bilo je 9 ± 3,46 godina, a kod
bolesnika s PPMS-om 4,25 ± 4,10 godina. Nije bilo statistički značajnih razlika u rezultatima
u kontrolnim laboratorijskim parametrima za limfocite, neutrofilne granulocite i jetrene enzime
mjesec dana nakon primjene druge infuzije prve doze okrelizumaba (P>0,05). Nije došlo do
značajnog pada serumskih albumina i globulina prije druge doze okrelizumaba (P>0,05).
Rezultati CD3+, CD3+CD4+ i CD3+CD8+ T-limfocita prije primjene prve doze okrelizumaba
iznosili su 1275,00 (1005,00-1483,00), 744,00 (678,00-891,00) i 343,00 (302,00-508,00)
stanica/μL. Prije primjene druge doze okrelizumaba vrijednosti su pale na 1097,00 (962,00-
1323,50), 675,00 (543,00-810,00) i 328,00 (262,00-486,50) stanica/μL bez statističke
značajnosti (P>0,05). Medijan CD19+ B-limfocita i CD3-CD16+CD56+ NK stanica prije
primjene prve doze okrelizumaba bio je175,00 (137,00-214,00) i 237,00 (190,00-338,00)
stanica/μL, a prije primjene druge doze okrelizumaba 4,00 (1,00-27,00) i 157,00 (135,50-
246,50) stanica/μL. Značajna deplecija dogodila se i kod B-limfocita (P<0.001) i kod NK
stanica (P=0.018).
Zaključak: Okrelizumab nije utjecao na promjenu laboratorijskih vrijednosti mjesec dana
nakon primjene druge infuzije prve doze i na elektroforezu proteina prije druge doze. Primjena
prve doze okrelizumaba uzrokovala je minimalni pad T-limfocita, ali značajni pad B- limfocita
i NK stanica. |
| Abstract (english) | Aim: To show and compare the immunophenotyping of T-lymphocytes, Blymphocytes
and NK cells before the administration of the first and before the administration
of the second dose of ocrelizumab in patients with MS in the KBC Split from January 1, 2019
to December 31, 2021.
Subjects and methods: 22 MS patients older than 18 years who were treated with ocrelizumab
at the KBC Split Neurology Clinic in the specified three-year period were included. Data on
gender, age, type of MS and the average duration of the disease from the diagnosis of MS to
the first administration of ocrelizumab were analyzed. Laboratory findings collected up to 2
days before the first infusion of the first dose and one month after the administration of the
second infusion of the first dose of ocrelizumab and cell immunophenotyping and protein
electrophoresis before the first and before the second dose of ocrelizumab were compared.
Statistical significance was set at P<0.05.
Results: Out of a total of 22 respondents, 15 are female (68.2%), and 7 are male (31.8%). The
median age was 46.5, ranging from 37.5 to 53.25 years. The average duration of the disease
from the diagnosis of MS to the first administration of ocrelizumab in patients with RRMS was
9 ± 3.46 years, and in patients with PPMS 4.25 ± 4.10 years. There were no statistically
significant differences in the results of the control laboratory parameters for lymphocytes,
neutrophil granulocytes and liver enzymes one month after administration of the second
infusion of the first dose of ocrelizumab (P>0.05). There was no significant decrease in serum
albumin and globulin before the second dose of ocrelizumab (P>0.05). The results of CD3+,
CD3+CD4+ and CD3+CD8+ T-lymphocytes before administration of the first dose of
ocrelizumab were 1275.00 (1005.00-1483.00), 744.00 (678.00-891.00) and 343.00 (302.00-
508.00) cell/μL. Before administration of the second dose of ocrelizumab, the values decreased
to 1097.00 (962.00-1323.50), 675.00 (543.00-810.00) and 328.00 (262.00-486.50) cells/μL
without statistical significance (P>0.05). Median CD19+ B-lymphocytes and CD3-
CD16+CD56+ NK cells before administration of the first dose of ocrelizumab were 175.00
(137.00-214.00) and 237.00 (190.00-338.00) cells/μL, and before administration of the second
dose of ocrelizumab 4.00 (1.00-27.00) and 157.00 (135.50-246.50) cells/μL. Significant
depletion occurred in both B-lymphocytes (P<0.001) and NK cells (P=0.018).
Conclusion: Ocrelizumab did not affect the change in laboratory values one month after
administration of the second infusion of the first dose and on protein electrophoresis before the
second dose. Administration of the first dose of ocrelizumab caused a minimal decrease in Tlymphocytes,
but a significant decrease in B-lymphocytes and NK cells. |
