大剂量IL-2活化的HLA半相合异基因造血干细胞治疗10例晚期难治性肾癌的疗效观察  

Efficacy of Large Doses of IL-2-Activated HLA Haploidentical Peripheral Blood Stem Cells on 10 Cases of Refractory Metastatic Renal Cell Carcinoma

作　　者：曹水[1] 王运良[2] 任宝柱[1] 张新伟[1] 张维红[1] 韩颖[1] 于津浦[1] 任秀宝[1] 

机构地区：[1]天津医科大学附属肿瘤医院生物治疗科天津市肿瘤防治重点实验室,天津市300060 [2]河北省保定市第一中心医院肿瘤科

出　　处：《中国肿瘤临床》2011年第12期712-715,共4页Chinese Journal of Clinical Oncology

基　　金：国家十五科技攻关引导项目(编号:2005BA740C);天津市科技创新基金项目(编号:06FZZDSF01500)资助~~

摘　　要：目的:传统的免疫治疗对晚期难治性肾癌的疗效非常有限,因为肿瘤自身产生了免疫耐受,本研究的目的是探讨大剂量IL-2活化的HLA半相合异基因造血干细胞治疗晚期难治性肾癌的临床疗效。方法:10例晚期肾癌患者以及作为供者的其HLA半相合的亲属入组。所有患音均接受1个疗程的haplo-PBSCs治疗,评估临床疗效和免疫学反应。结果:经IL-2活化后获得的HLA半相合的haplo-PBSCs总数为(2.3～5.5)×10^(10)。活化后,NK细胞和活化淋巴细胞亚群(CD69^+和CD25^+)比例明显升高,而且对肾癌细胞的杀伤活性也明显增强。治疗后,2例部分缓解(PR),6例疾病稳定(SD),2例疾病进展(PD),中位无进展生存期(mPFS)为5.5个月(3～14个月)。结论:传统的免疫治疗无效的晚期难治性肾癌患者,采用IL-2活化的HLA半相合异基因造血干细胞治疗可以产生明显的抗肿瘤效应,并且有良好的耐受性。Objective： To evaluate the clinical efficacy of infusion of high-dose interleukin （ IL ）-2-activated allogeneic haploi- dentical peripheral blood stem cells （ haplo-PBSCs ） among patients with advanced intractable renal cell carcinoma （ RCC ）. Methods： Ten advanced RCC patients and haploidentical relatives were enrolled as donors for haplo-PBSCs in this treatment. All patients accepted one cycle of activated haplo-PBSCs. The clinical and immunologic responses were evaluated. Results： A range from 2.3 to 5.5 × 1010 of activated haplo-PBSCs were harvested after exposure to rhIL-2, along with a significant increase in the proportion of natural killer （ NK ） cells and activated lymphocytes （ CD69＋ and CD25＋ ）, and enhanced cytotoxicity of haplo-PBSCs for renal cell carcino- ma. After treatment, 2 （ 2/10 ） cases of partial remission （ PR ）, 6 （ 6/10 ） cases of stable disease （ SD ）, and 2 （ 2/10 ） cases of progres- sive disease （ PD ） were identified among the 10 patients. The median progression-free survival （ PFS ） of all 10 patients was 5.5 months （ 3-14 months ）. Conelusion： The adoptive transfusion of IL-2-activated haplo-PBSCs can induce sustained anti-tumor effects for advanced intractable RCC patients who do not respond to conventional immunotherapy.

关 键 词：IL-2 单倍相合 异基因造血干细胞 肾癌 抗肿瘤效应 

分 类 号：R737.11[医药卫生—肿瘤]