化疗联合自体DCIK细胞治疗急性白血病的临床研究  

Clinical research of the efficacy of chemotherapy in combination with DCIK cells in acute leukemia

作　　者：刘跃均[1] 吴德沛[1] 孙爱宁[1] 仇惠英[1] 金正明[1] 唐晓文[1] 傅琤琤[1] 马骁[1] 韩悦[1] 苗瞄[1] 陈峰[1] 赵晔[1] 

机构地区：[1]苏州大学附属第一医院江苏省血液病研究所,苏州215006

出　　处：《中国免疫学杂志》2010年第6期552-556,共5页Chinese Journal of Immunology

基　　金：江苏省135重点人才基金项目(RC2002033);江苏省135重点实验室;苏州大学青年教师基金(Q3122634);苏大附一院青年自然基金预研项目(QY05001)资助

摘　　要：目的:采用体外培养的树突状细胞(Dendritic cell,DC)致敏、细胞因子诱导激活的杀伤细胞(Dendritic Cells with Cytokine-induced Killer,DCIK)治疗急性白血病患者,探讨DCIK细胞过继免疫治疗的临床疗效及安全性。方法:采用血细胞分离机分离患者外周血中单个核细胞,在体外诱导培养成DCIK细胞,流式细胞术检测外周血淋巴细胞免疫表型,MTT法检测DCIK细胞对人红白血病细胞K562的杀伤活性。经过质量检定合格后,回输给患者。观察输注期间的不良反应,治疗结束后定期复查患者血液学及遗传学缓解情况。结果:①回输给患者的细胞群中,CD3+CD56+细胞占(38.62±9.32)%,其对白血病细胞株K562的杀伤率为(57.6±2.9)%,回输后患者外周血CD8+、CD56+细胞百分比分别为(36.93±5.78)%、(41.94±13.15)%。②21例患者共接受50例次DCIK细胞治疗,1例接受9疗程治疗,1例接受7疗程治疗,2例接受4疗程治疗,1例接受3疗程治疗,4例接受2疗程治疗,11例接受1疗程治疗。自DCIK细胞回输开始,随访至2009年11个月底,中位随访时间14个月(2～44),3年总生存率(Overall survival,OS)、3年无事件生存率(Event free survival,EFS)分别为(61.9±18.5)%、(43.1±15.7)%。13/21例(61.9%)持续缓解,中位持续缓解时间为17个月(2～44),共8例复发(1例分子水平复发,7例血液学复发)。③21例患者中,DCIK细胞治疗时处于第1次缓解(First complete remission,CR1)期15例,11例持续缓解,4例复发;≥第2次缓解(Second complete remission,CR2)期6例,4例复发,2例持续缓解。④所有患者输注过程安全,无输注相关不良反应,无心电图及肝肾功能损害。结论:DCIK细胞治疗明显改善急性白血病的临床症状,是一种安全有效的治疗方法。Objective：To evaluate the efficacy of chemotherapy combined with co-cultured dendritic cells and cytokine-induced killer（DCIK） cells in the patients with acute leukemia.Methods：Peripheral blood mononuclear cells from the patients were collected with blood cell separator,DCs and CIK cells were induced in vitro and then co-cultured.Immunophenotype changes were analyzed by flow cytometry;MTT assay was used to evaluate the cytotoxic effect of DCIK cells against K562 cells.After certain quality control assays,the qualified DCIK cells were administrated to the patients ex vivo.The side effects were observed during the treatment.Hematological and chromosomal changes were monitored regularly after the treatment.Results：① Among the DCIK cells,the proportion of CD3＋CD56＋cells was（38.62±9.32）%.The cultured DCIK cells inhibited the K562 cells by（57.6±2.9）%.The ratio of CD8＋ and CD56＋ cells in peripheral blood of the patients were（36.93±5.78）%,（41.94±13.15）% after DCIK infusion respectively.②21 cases received a total of 50 courses of DCIK cells,3 patients received 9,7 and 3 courses respectively,2 patients for 4 courses,4 patients for 2 courses and 11 patients for one course of the treatment.The median follow-up 14（2～44）months.The 3-year overall survival rate and 3-year event free survival rate were（61.9±18.5）% and （43.1±15.7）%,respectively.13/21（62%） patients acquired continuously complete remission.The Median time of continuously complete remission was 17 months（2 to 44 months）.8/21 patients relapsed（1 in molecular relapse,7 in hematological relapse）.11 of the 15 patients who received DCIK cell therapy in the first complete remission （CR1） remained continuously complete remission at the time of this study.4 patients relapsed after CR by 5,7,6 and 29 months,respectively.There were 6 patients who underwent treatment of DCIK cell therapy,in whom 2 patients were in no less than the second complete remission （CR2）,remaining the continnously complete rem

关 键 词：DCIK细胞 急性白血病 免疫治疗 

分 类 号：R730.3[医药卫生—肿瘤]