含胸腺肽免疫增强的自体CIK细胞联合IL-2方案治疗高龄弥漫大B细胞淋巴瘤  

Treatment of diffuse large B cell lymphoma with combined thymic peptide-enhanced autologous cytokine induced killer cells and IL-2 in aged patients

作　　者：杨洋[1] 杨波[1] 脱帅[2] 卢学春[1] 朱宏丽[1] 脱朝伟[2] 蔡力力[1] 迟小华 于睿莉[1] 陈云燕 张文英[1] 刘洋[1] 王瑶[1] 代汉仁[1] 韩为东[1] 张峰[5] 姚善谦[1] 

机构地区：[1]解放军总医院南楼血液科,北京100853 [2]解放军第202医院,沈阳110003 [3]解放军第二炮兵总医院药学部,北京100800 [4]解放军第二炮兵后勤部保健办,北京100800 [5]中国科学院北京基因组研究所,北京100029

出　　处：《军医进修学院学报》2012年第5期441-443,459,共4页Academic Journal of Pla Postgraduate Medical School

基　　金：国家自然科学基金项目(30772597);解放军总医院科技创新苗圃基金(11KMM24);中央保健研究基金(B2009B115);科技部新药创制重大专项(2008ZXJ09001-019)~~

摘　　要：目的评价含胸腺肽免疫增强的自体CIK细胞联合IL-2(TCIL-2)方案治疗高龄弥漫大B细胞淋巴瘤的有效性和安全性。方法采集预先接受胸腺五肽免疫增强治疗的4例高龄弥漫大B细胞淋巴瘤(DLBCL)患者外周血单个核细胞,在体外经干扰素-γ(IFN-γ)、白介素-2(IL-2)、抗CD3单克隆抗体诱导成CIK细胞,回输细胞数为2×109-3×109个,回输后应用IL-2 100mU/d,皮下注射,连续10d。28d为1个周期,共完成24个周期的自体CIK细胞输注。观察治疗前后细胞免疫功能、肿瘤相关生物学指标变化。结果 2例接受8个周期的CIK细胞输注,2例接受4个周期的输注,回输后所有患者未出现不良反应。CIK细胞治疗后CD3+、CD3+CD8+、CD3+CD56+细胞比例明显升高(P<0.05),β2微球蛋白水平显著下降(P<0.05)。3例达完全缓解,1例完成8周期的CIK细胞输注后一度达良好的部分缓解,但最终因急性心肌梗死和淋巴瘤持续进展而死亡。结论自体CIK细胞联合IL-2治疗高龄弥漫大B细胞淋巴瘤安全有效。Objective To assess the efficiency and safety of combined thymic peptide-enhanced autologous cytokine induced killer （CIK） cells and IL-2 in treatment of diffuse large B cell lymphoma in aged patients. Methods Peripheral blood mononuclear cells （PBMC） were collected from 4 aged patients with diffuse large B cell lymphoma. CIK cells were induced with in vitro interferon gamma （IFN- γ ）, IL-2 and anti-CD3 monoclonal antibody （mAb）. Immune function of the cells and tumor-related biological indexes of the patients were observed after 2 × 10^9 -3 × 109 autologous CIK cells were re-transfused into the patients each time and IL-2 100mU/d was subcutaneously injected for 10 days, 28 days a cycle for 24 cycles. Results Two patients received 8 cycles of CIK cells transfusion and 2 patients received 4 cycles of CIK cells transfusion. No adverse reaction occurred in them. The number of CD3^＋, CD3^＋ CD8^＋ and CD3^＋ CD56^＋was significantly greater and the serum β2-microglobulin level was markedly lower after CIK cells transfusion than before CIK cells transfusion（P〈0.05）. Complete remission was achieved in 3 patients and 1 patient died of acute large-area myocardial infarction and persistent progression of lymphoma although partial remission was achieved after 8 cycles of CIK cells transfusion. Conclusion Combined autologous CIK cells transfusion and IL-2 is safe and effective for large B cell lymphoma in aged patients.

关 键 词：细胞因子诱导的杀伤细胞 胸腺肽 淋巴瘤 弥漫大B细胞 老年人 

分 类 号：R733.41[医药卫生—肿瘤]