DC-CIK细胞输注治疗急性髓细胞白血病50例分析  

Study on the treatment of auto-hematopoietic stem cell transplantation(Auto-HSCT) combined dendritic cells-cytokine-induced killer cells(DC-CIK cells) pulsed with freeze-thaw leukemia antigen infusions for acute myeloid leukemia

作　　者：龚奕[1] 陈幸华[1] 张曦[1] 张诚[1] 高力[1] 高蕾[1] 彭贤贵[1] 孔佩艳[1] 王庆余[1] 

机构地区：[1]第三军医大学新桥医院血液科,重庆400037

出　　处：《重庆医学》2011年第30期3039-3041,共3页Chongqing medicine

基　　金：国家自然科学基金资助项目(81070388);重庆市医学重点学科建设基金资助项目(2006C026);重庆市自然科学基金重点项目(2009BA5056);第三军医大学临床科研基金资助项目(2010D249)

摘　　要：目的观察自体外周血移植联合自身白血病细胞冻融抗原负载的树突状细胞-细胞因子诱导的杀伤细胞(DC-CIK)细胞输注治疗急性髓细胞白血病的安全性和临床疗效。方法 50例初发急性髓细胞白血病患者抽取未缓解的骨髓细胞制备自身白血病细胞冻融抗原,在自体外周血干细胞采集时留取部分单个核细胞培养DC-CIK细胞,利用制备好的白血病冻融抗原共培养激活扩增DC-CIK细胞。待患者自体外周血造血干细胞移植后30～60d输注自身白血病细胞冻融抗原负载的DC-CIK细胞,每例每疗程回输细胞总数大于7×109,同时给予白细胞介素-2(IL-2)200万单位皮下注射,每天1次,连续10d皮下注射。观察患者接受细胞输注治疗的安全性及临床疗效,并与既往接受自体外周血移植但未输注DC-CIK细胞治疗的52例急性髓细胞白血病患者在临床疗效方面进行比较分析。结果接受自身白血病细胞冻融抗原负载的DC-CIK细胞输注治疗的50例患者中,4例在DC-CIK细胞输注过程中出现一过性畏寒发热反应,但最高体温均低于39℃(37.8～38.5℃),经物理降温后恢复正常。其他患者均未出现异常不适反应。患者接受DC-CIK治疗结束后随访6～24个月,总体生存率(OS)、无病生存率(DFS)均高于同期未输注DC-CIK细胞治疗的对照组患者,其中随访24个月时OS、DFS均显著高于未输注DC-CIK细胞治疗的对照组患者(P<0.05)。结论对急性髓细胞白血病患者采用自体外周血移植联合自身白血病细胞冻融抗原负载的DC-CIK细胞输注治疗不良反应小,有助于清除移植后微小残留病和提高患者生存率,提示该治疗方法对急性髓细胞白血病具有良好的治疗应用前景。Objective To observe the safety and clinical efficacy of auto-hematopoietic stem cell transplantation （Auto-HSCT） combined with infusions of dendritic cells-cytokine-induced killer cells （DC-CIK） pulsed with freeze-thaw leukemia antigen in the treatment of acute myeloid leukemia. Methods Fifty patients with acute myeloid leukemia were included in this clinical research. Before transplantation,bone marrow ceils were extracted for preparation of freeze-thaw leukemia antigen, and mononuclear cells were collected during harvesting of peripheral hematopoietic stem cells. Denritic cells were separated from mononuclear cells and pulsed with prepared freeze-thaw leukemia antigen and then co-cultured with mononuclear cells and cytokines to produce DC-CIK cells. Patients were transfused with DC CIK cells and IL2 after hematopoietic reconstitution （between ＋ 30d and ＋ 60d）. Thera- peutic efficacy and adverse effects were observed. Results During treatment with DC-CIK cells,only 4 cases of total 50 patients happened transient fever with body temperature lower than 39 ℃ （37.8-- 38.5℃ ）, and no other adverse effects were observed. Elevated percentages of overall survival rates （OS） and disease free survival rates （DFS） were also observed in patients accepted DC- CIK therapy,which demonstrated a significant difference between DOCIK therapy group and non DC-CIK therapy group after 24- month follow up（OS：68.0% vs 50.0%,P〈0.05;DFS：62.0% vs 40.4%,P〈0.05）. Conclusion Auto-hematopoietic stem cell transplantation （Auto-HSCT） combined with infusions of dendritic cells-cytokine-induced killer cells （DC-CIK） pulsed with freeze- thaw leukemia antigen is a safe and effective method,and is worth appling in the treatment of AML.

关 键 词：抗原 外周血干细胞移植 白血病 髓样 急性 

分 类 号：R733.7[医药卫生—肿瘤]