异基因造血干细胞移植后序贯输注供者CIK细胞治疗9例复发/难治性血液肿瘤疗效的初步探讨  

Allogeneic hematopoietic stem cell transplantation followed by sequential infusion of donor-derived cytokine induced killer cells for relapsed/ refractory hematologic malignancy: A preliminary study of 9 cases

作　　者：罗云[1] 张萍[1] 张颖[1] 娄世锋[1] 周慷[1] 邓建川[1] 陈姝[1] 陈林[1] 

机构地区：[1]重庆医科大学附属第二医院血液科,重庆400010

出　　处：《肿瘤》2012年第7期546-550,共5页Tumor

摘　　要：目的:评价复发/难治性血液肿瘤患者在未缓解状态下直接采用异基因干细胞移植(allogeneic-peripheral hemopoietic stem cell transplantation,Allo-PBSCT)后,序贯输注体外培养获得的供者细胞因子诱导的杀伤(cytokine induced killer,CIK)细胞以防治肿瘤复发的疗效及并发症。方法:共收集9例复发/难治性的血液肿瘤患者,均在未缓解状态下直接进行Allo-PBSCT;在患者造血重建后,利用血细胞分离机采集供者外周血中的单个核细胞,体外培养成CIK细胞,分数次输注给患者,观察治疗情况,不良反应及预后。结果:9例患者均顺利造血重建,移植后均获得完全缓解;CIK细胞输注后,4例患者发生移植物抗宿主病,加强免疫抑制治疗后均获好转,1例患者于移植后59d死于感染,其余患者现已中位随访9.2(2～20)个月,生活状况良好。结论:Allo-PBSCT序贯输注供者CIK细胞治疗具有较好的疗效,可以挽救治疗复发/难治性血液肿瘤患者,值得进一步扩大病例研究。Objective： To explore the efficacy and complications of allogeneic peripheral blood stem cell transplantation （AIIo-PBSCT） followed by sequential infusion of donor-derived cytokine induced killer （CIK） cells for relapsed/refractory hematologic malignancy. Methods： Nine patients with relapsed/ refractory hematologic malignancy without complete remission received AIIo-PBSCT. After hematopoietic reconstitution, the donor-derived peripheral blood mononuclear cells were collected by blood cell separator and cultured into CIK cells in vitro. The CIK cells were infused back into the patients. The therapeutic efficacy, adverse reactions and prognosis were observed. Results： All patients engrafted. Complete remission was also achieved in all patients. After infusion of CIK cells, four patients developed graft-versus-host disease （GVHD） which was relieved by reinforced immunosuppression therapy. One patient died of infection 59 days after AIIo-PBSCT, and the other 8 patients survived at a median follow- up of 9.2 months （2-20 months）. Conclusion： AIIo-PBSCT followed by sequential infusion of donor-derived CIK cells can salvage the patients with relapsed/refractory hematologic malignancy and it is worthy of further large-scale study.

关 键 词：白血病 造血干细胞移植 移植物抗宿主病 细胞因子诱导的杀伤细胞 

分 类 号：R733.71[医药卫生—肿瘤]