地西他滨联合自体CIK细胞治疗2例高龄急性髓系白血病的疗效观察  

Curative Effect of Decitabine Combined with Cytokine-Induced Killer Cells in Two Elderly Patients with Acute Myeloid Leukemia

作　　者：常城[1] 杨波[1] 张琳[2] 朱宏丽[1] 卢学春[1] 郭搏[1] 蔡力力[3] 韩为东[4] 王瑶[4] 范辉[1] 李素霞[1] 刘洋[1] 杨洋[1] 翟冰[1] 冉海红[1] 林洁[1] 张峰[5] 

机构地区：[1]中国人民解放军总医院南楼血液科,北京100853 [2]中国人民解放军总医院血液科,北京100853 [3]中国人民解放军总医院南楼临检科,北京100853 [4]中国人民解放军总医院基础所免疫室,北京100853 [5]中国科学院北京基因组研究所,北京100029

出　　处：《中国实验血液学杂志》2013年第1期62-67,共6页Journal of Experimental Hematology

基　　金：中央保健研究基金(编号B2009B115);解放军总医院科技创新苗圃基金(编号11KMM24);解放军总医院“百病妙诀”培育项目《细胞因子诱导的杀伤细胞(CIK)疗法在老年血液肿瘤的应用研究》;国家自然科学基金(编号81273597,30772597,30873086,81172986);科技部新药创制重大专项(编号2008ZXJ09001-019)

摘　　要：本研究旨在观察低甲基化药物地西他滨联合自体细胞因子诱导的杀伤细胞(CIK)治疗老年急性髓系白血病(AML)的安全性及有效性。本科于2006-2012年收治2例80岁以上老年AML患者(M4型和M6型),均继发于骨髓增生异常综合征。对这2例患者先后采取单用自体CIK细胞输注、地西他滨或(和)自体CIK细胞方案治疗,系统观察了2例CIK治疗前后淋巴细胞亚群、临床相关指标(血液学反应、输血频率、白血病相关基因表达、缓解情况、生活质量)及生存期的变化。结果表明,与单用自体CIK细胞输注和单用地西他滨治疗相比,地西他滨联合自体CIK细胞治疗方案可减轻骨髓抑制程度,降低输血频率及输血量,延长部分缓解持续时间,同时表达的白血病相关基因减少,生存期显著延长,患者生活质量得到明显改善。结论:地西他滨联合自体CIK细胞治疗老年AML患者安全有效。This study was aimed to evaluate the effectiveness and safety of low methylation drug decitabine combined with autologous cytokine induced killer cells （CIK） to treat the elderly patients with acute myeloid leukemia （AML）. Two AML patients aged over 80 years old were diagnosed and treated in our department from 2006 to 2012; both companied with MDS history, and one case was M4-type, another case was M6-type according to FAB classification. The changes in lymphocyte subsets, hematologic response, transfusion frequency, leukemic gene expression, obtaining CR or PR, quality of life and survival time of the patients with different treatment regimen （ decitabine alone ; CIK alone; decitabine combined with CIK） were systematically observed. The results showed that therapy of decitabine combined with CIK cells could reduce bone marrow suppression extent, decrease the frequency and volume of blood transfusion, and prolong the duration of partial remission, compared with the single use of CIK cell infusion and single use of decitabine treatment. Meanwhile, the kinds of expressed genes associated with leukemia decreased and the survival time was prolonged obviously. The patients＇ life quality significantly improved. It is concluded that decitabine combined with CIK for treatment of elderly patients with AML is safe and effective.

关 键 词：急性髓系白血病 地西他滨 细胞因子诱导的杀伤细胞 老年人 

分 类 号：R733.71[医药卫生—肿瘤] R979.1[医药卫生—临床医学]