DC-CIK联合氟达拉滨治疗老年慢性淋巴细胞白血病的临床研究  

The clinical study of DC-CIK combined with fludarabine in treatment of elderly chronic lymphocytic leukemia

作　　者：孙薏[1] 席洁琳[1] 苏毅[2] 钟国成[1] 张明慧[1] 岳伦莉[1] 王奎 

机构地区：[1]解放军第452医院血液肿瘤科,四川成都610021 [2]成都军区总医院血液科,四川成都610083

出　　处：《西部医学》2016年第4期498-500,504,共4页Medical Journal of West China

基　　金：四川省卫生厅科研课题(110490)

摘　　要：目的分析树突状细胞(DC)与细胞因子诱导的杀伤细胞(CIK)为效应细胞的过继免疫疗法(DC-CIK免疫治疗)联合氟达拉滨治疗老年慢性淋巴细胞白血病(CLL)患者的免疫效应和临床疗效。方法将48例老年CLL患者分为化疗组21例,行氟达拉滨单药化疗和联合组27例,除接受氟达拉滨化疗外,还给予DC-CIK免疫治疗。并检测两组患者治疗前后的免疫学指标,比较治疗后两组患者的临床疗效、骨髓抑制及感染发生情况。结果治疗前,两组患者的免疫学指标差异无统计学意义(P>0.05)。治疗后,联合组患者血清Hsp70、Thl/Th2水平均较化疗组显著增加(P<0.05);TGF-β、CD4+CD25+Treg阳性率较化疗组显著降低(P<0.05)。治疗后,联合组患者的PS评分、LDH等指标均优于化疗组,差异具有统计学意义(P<0.05)。治疗后,化疗组Ⅲ°及Ⅳ°骨髓抑制发生率差异无统计学意义(P>0.05),感染发生率明显高于联合组,差异具有统计学意义(P<0.05)。总反应率联合组OR为77.78%,化疗组OR为66.67%,差异无统计学意义(P>0.05)。结论 DC-CIK免疫治疗与氟达拉滨联合应用于老年CLL患者具有良好的协同疗效,是治疗老年CLL患者的可选方法之一。Objective This study was aimed to evaluate the immunological effect and clinical effect of immunotherapy which consist of dendritic cells（DC）and cytokine-induced killer cell（CIK）combined with fludarabine on senile patients with chronic lymphocytic leukemia（CLL）.Methods 48 senile patients with CLL were assigned to chemotherapy group and joint group.21 patients of chemotherapy group were treated by fludarabine only.27 patients of joint group were treated by adoptive immunotherapy（DC-CIK）combined with fludarabine.At the same time,a variety of immunological indexes of all patients before and after treatment were recorded.After treatment,the clinical effect,myelosuppression and infection between two groups was compared.Results After treatment,the immunological indexes of all patients were better than that before treatment（P〈0.05）.After treatment,the incidence of III°and IV°of myelosuppression in chemotherapy was higher than that of the joint group,but there was no significant difference（P〈0.05）.The infection incidence of chemotherapy group was significantly higher than that of joint group（P〈0.05）.After treatment,the quality of life and clinical index in joint group were better than that of chemotherapy group（P〈0.05）.The overall response（OR）rate of the joint group and chemotherapy group were 77.78% and 66.67%,respectively（P〈0.05）.Conclusion Fludarabine and DC-CIK have good synergistic therapeutic effect for elderly CLL.

关 键 词：慢性淋巴细胞白血病(CLL) 免疫疗法 树突细胞 杀伤细胞 化疗 

分 类 号：R733.7[医药卫生—肿瘤]