自体造血干细胞移植后白细胞介素-2免疫治疗对急性白血病长期生存的影响  

Effect of interleukin-2 immunotherapy after autologous hematopoietic stem cell transplantation of acute leukemia to long-term survival

作　　者：郭智[1] 何学鹏[1] 陈惠仁[1] 杨凯[1] 陈鹏[1] 王丙然[1] 张媛[1] 刘晓东[1] 

机构地区：[1]北京军区总医院血液科,100700

出　　处：《中华临床医师杂志（电子版）》2011年第1期56-59,共4页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的观察急性白血病行自体造血干细胞移植(AHSCT)后应用大剂量白细胞介素-2(IL-2)行免疫治疗的临床疗效。方法回顾分析北京军区总医院血液科2005年1月至2010年1月共15例急性白血病患者AHSCT后行大剂量IL-2治疗(治疗组),与12例急性白血病患者单纯AHSCT后未行IL-2治疗(对照1组)及15例随机挑选的急性白血病患者缓解后行异基因造血干细胞移植(allo-HSCT)(对照2组)进行对比,对三组患者进行随访观察,评价其治疗效果,并检测三组患者外周血T淋巴细胞亚群,观察免疫功能的变化。结果治疗组的外周血T淋巴细胞亚群CD3+、CD4+、CD8+、CD4+/CD8+水平明显提升,随访结束时统计复发或死亡率:治疗组为26.7%,对照1组为41.7%,对照2组为26.7%;中位生存期:治疗组为28.5个月(5～58个月),对照1组为22.4个月(5～55个月),对照2组31.2个月(4～60个月)。结论急性白血病AHSCT后行大剂量IL-2治疗能提高患者的免疫功能,减少移植后复发率,长期生存率优于单纯AHSCT,接近allo-HSCT疗效,且减少了移植相关死亡率,是一种安全有效的治疗方法。Objective To observe clinical efficacy of high-dose interleukin-2（IL-2） immunotherapy after autologous hematopoietic stem cell transplantation（AHSCT） of acute leukocythemia.Methods Review 15 acute leukocythemia patients treated with high-dose interleukin-2 after AHSCT （therapy group） from January 2005 to January 2010,compared with 12 randomly selected acute leukocythemia patients without high-dose interleukin-2 therapy after AHSCT（control group 1） and 15 randomly selected acute leukocythemia patients with allogene hematopoietic stem cell transplantation（allo-HSCT） therapy after remission（control group 2） of Beijing Military General Hospital.Detect T lymphocyte subsets in peripheral blood of the 3 groups,observe changes in their immune function,and all patients were followed up.Results There was an increase CD3＋,CD4＋,CD8＋,CD4＋/CD8＋ in T lymphocyte subsets in peripheral blood of the therapy group.The recurrence rate at the end of follow up：therapy group 26.7%,control group 1 41.7%;control group 2 26.7%;median survival time：therapy group 28.5±3.0（5-58）months,control group 1 22.4±2.0（5-55）months,control group 2 31.2±2.0（4-60）months.Conclusions High-dose interleukin-2 immunotherapy of acute leukocythemia patients after AHSCT may improve immune function,reduce recurrence rate after transplantation and prolong survival time.The efficacy is comparable to the allo-HSCT gruop,and also reduce the transplate-related mortality rate.

关 键 词：白血病 造血干细胞移植 白细胞介素2 免疫法 长期生存 

分 类 号：R733.71[医药卫生—肿瘤]