荷载自体白血病抗原的HLA半相合DC-CIK联合CAG方案治疗老年AML  

HLA haploidentical DC-CIKs loading autologous leukemia antigens in combination with CAG regimen in elderly AML patients treatment

作　　者：苏毅[1] 易海[1] 赖思含[1] 范方毅[1] 付利[1] 何光翠[1] 刘一岚 侯严堂[1] 孙浩平[1] 王译[1] 邱玲[1] 缪晓娟[1] 李业成[1] 

机构地区：[1]成都军区总医院血液内科,四川成都610083

出　　处：《中国输血杂志》2013年第11期1080-1083,共4页Chinese Journal of Blood Transfusion

摘　　要：目的观察荷载自体白血病抗原的HLA半相合树突状细胞．细胞因子诱导的杀伤细胞（DC．CIK）联合CAG方案治疗老年急性髓系白血病（AML）的安全性和有效性。方法选取老年AML124例，采用化疗CAG方案，其中65例CAG方案化疗后输注荷载自体白血病抗原的HLA半相合DC．CIK细胞作为细胞组，其余59侧单纯使用CAG方案化疗作为对照组。对2组中达到完全和部分缓解的患者均按各自的原方案巩固治疗，半年内每2个月1次、半年后每3个月1次、1年以上每半年1次，并对其跟踪随访。结果所有124名患者均完成了2个以上的疗程，细胞组：65例中完全缓解（CR）54例（83．08％）、部分缓解（PR）7例（10．77％）、未缓解（NR）4例（6．15％），总有效率93．85％；对照组：59例中完全缓解34例（57．63％）、部分缓解10例（16．95％）、未缓解15例（25．42％），总有效率74．58％。巩固治疗实施后细胞组、已随访6—53个月，存活〉12个月者32例、〉24个月者16侧；对照组已随访7～31个月，存活〉12个月者22例、〉24个月者4例，使用Kaplan-Meier分析两组总生存率有统计学差异（P〈0．05）。Objective To observe the safety and efficacy of treating elderly acute myeloid leukemia patients with autolo- gous leukemia antigens loading HLA haploidentical dendritic cells-cytokine-induced killer cells （I）C-CIKs） and CAG regi- men. Methods A total of 124 ederly acute myeloid leukemia patients were carried out CAG chemotherapy. In test group, HLA haploidentical DC-CIKs loading autologous leukemia antigens were infused to 65 cases after CAG chemotherapy. And 59 cases only fulfilled CAG chemotherapy were divided to control group. In both groups, complete and partial response cases were continuing with the same therapy hi-monthly in half a year, once every three months after half a year and once every six months after one year. Results All the patients completed two or more treatments, in test group, complete remission in 54 ea- ses （83. 08% ） ,partial remission in 7 cases （ 10. 77% ） ,not remission in 4 cases （6. 15% ） ,the total efficiency was 93. 85% ~ In control group, complete remission in 34 cases （57.63%）, partial remission in I 0 cases （ 16. 95 % ） ,not remission in 15 cases （25.42%） ,the total efficiency was 7.4. 58%. In test group,patients were followed up for 6 ~53 months ~ter consolida- tion therapy, and 32 cases survived more than 12 months, 16 cases survived more than 24 months. In control group,patients were followed up for 7 ~ 31 months, and 22 cases survived more than 12 months,4 cases survived more than 24 months： The difference was statistically significant by the Kaplan-Meier survival analysis between two groups （P 〈 0. 05 ）. Conclusion Treating elderly acute myeMd leukertlia patients with CAG regimen combined with HLA haploidentical DC-CIKs loading autologous leukemia antigens is safe and effective.

关 键 词：白血病抗原 自体 HLA半相合 树突状细胞 杀伤细胞 细胞因子诱导 急性髓系白血病 老年 CAG方案 过继性细胞免疫治疗 

分 类 号：R457.7[医药卫生—治疗学] R733.71[医药卫生—临床医学]