慢性淋巴细胞白血病患者PD-1免疫抑制剂治疗的疗效及预后  

Study on the Therapeutic Effect and Prognosis of PD-1 Immunosuppressant in Patients with Chronic Lymphoblastic Leukemia

作　　者：仝佳音 侯韶英 杨学文[1] 赵小强[1] 刘静静 TONG Jiayin;HOU Shaoying;YANG Xuewen(The First Affiliated Hospital of Henan University of Science and Technology,Luoyang,471000)

机构地区：[1]河南科技大学第一附属医院,471000 [2]山西省晋城市人民医院,048000

出　　处：《实用癌症杂志》2024年第6期953-956,共4页The Practical Journal of Cancer

摘　　要：目的探究慢性淋巴细胞白血病(chronic lymphocytic leukemia,CLL)患者程序性死亡受体(programmed cell death1,PD-1)免疫抑制剂治疗的疗效及预后。方法选取96例CLL患者作为研究对象,根据随机数字法分为研究组(n=48)和对照组(n=48)。对照组给予基础治疗措施,并注意患者的心电图、肝肾功能等变化;研究组在对照组治疗的基础上,采用卡瑞利珠单抗治疗。比较2组研究对象的基本临床资料;治疗前、后外周血T淋巴细胞亚群水平;总体生存率、完全缓解率及无进展生存期;不良反应情况。结果2组研究对象的性别、平均年龄、WBC、淋巴细胞绝对数、淋巴细胞百分比、HGB、PLT等临床资料无明显差异(P>0.05)。研究组患者治疗后CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、INF-γ、IL-2的表达均高于治疗前,同时也高于对照组(P<0.05);但CD8^(+)、NK、IL-4、IL-5的表达明显降低,同时也低于对照组(P<0.05)。研究组患者的无进展生存期明显长于对照组(P<0.05),同时总体生存率和完全缓解率均高于对照组(P<0.05)。研究组患者总不良反应率低于对照组,但差异无统计学意义(P>0.05)。结论PD-1免疫抑制剂治疗CLL患者的疗效及预后均明显优于常规治疗,可为该病的临床治疗提供有效参考价值。Objective To investigate the therapeutic effect and prognosis of programmed cell death 1(PD-1)immunosuppressive therapy in patients with chronic lymphocytic leukemia(CLL).Methods 96 CLL patients were selected and were divided into the study group(n=48)and the control group(n=48)according to the random number method.The control group was given basic treatment measures,and the changes of ECG,liver and kidney function were noted;On the basis of the control group,the study group was treated with carrilizumab.The basic clinical data of the two groups were compared;T lymphocyte subsets in peripheral blood before and after treatment;Overall survival rate,complete remission rate and progression free survival;Adverse reactions.Results There was no significant difference in gender,mean age,WBC,absolute number of lymphocytes,percentage of lymphocytes,HGB,PLT and other clinical data between the 2 groups(P>0.05).After treatment,the patients in the study group had CD3^(+),CD4^(+),CD4^(+)/CD8^(+),inf-γ.The expression of IL-2 was higher than that before treatment and also higher than that in the control group(P>0.05);But the expression of CD8^(+),NK,IL-4 and IL-5 was significantly lower than that of the control group(P>0.05).The progression free survival of patients in the study group was significantly higher than that in the control group(P>0.05),and the overall survival rate and complete remission rate were higher than those in the control group(P>0.05)The total adverse reaction rate of the study group was lower than that of the control group,but the difference was not significant(P>0.05).Conclusion The efficacy and prognosis of PD-1 immunosuppressant in CLL patients are significantly better than that of conventional treatment,which can provide an effective reference value for the clinical treatment of this disease.

关 键 词：慢性 淋巴细胞 白血病 PD-1 抑制剂 

分 类 号：R733.72[医药卫生—肿瘤]