自体 CIK 细胞联合化疗治疗老年急性髓细胞白血病的临床研究简

本研究旨在评价自体CIK细胞联合化疗治疗老年人急性白血病的有效性和安全性.采集5例老年急性白血病患者外周血单个核细胞,在体外经干扰素-γ（IFN-γ）、白介素-2（IL-2）、抗CD3单克隆抗体诱导成CIK细胞,回输至患者体内,28 d为1个疗程.观察治疗前后细胞免疫功能、感染发生、血红蛋白和输血依赖以及对自然病程的影响.结果表明：5例患者共接受46个周期的CIK细胞输注治疗,回输后所有患者均未出现不良反应；CIK细胞治疗后CD3＋、CD3＋ CD8＋、CD3＋ CD56＋细胞比例显著增高（P ＜0.05）；CIK细胞治疗可以有效减少AML患者的感染发生（P＜0.05）,缩短高热持续时间（P＜0.05）；在疾病稳定期,CIK细胞输注可以减少患者红细胞的输注量（P＜0.05）,稳定血红蛋白水平；CIK细胞输注虽不能改变病程的转归,但在患者疾病进展期以及终末期,采用化疗联合CIK治疗可使患者病情一度平稳,延长生存时间.结论：自体CIK细胞联合化疗对本组5例老年急性髓系白血病安全有效.

Clinical Study of Autologous Cytokine Induced Killer Cells Combined with Chemotherapy for Elderly Patients with Acute Myeloid Leukemia

This study was purposed to evaluate the effectiveness and safety of autologous cytokine induced killer （CIK） cells combined with chemotherapy in treatment of elderly patients with acute myeloid leukemia.Peripheral blood mononuclear cells （PBMNC） were isolated from 5 elderly patients with acute myeloid leukemia,and then augmented by priming with interferon gamma （IFN-γ） followed by IL-2 and monoclonal antibody （mAb） against CD3.The autologous CIK cells thus obtained were infused back to individual patients,28 days as one cycle.The changes in cellular immune function,incidence of infection,independence of haematoglobin or blood transfusion,and progression of disease were observed and assessed before and after therapy.The results showed that the 46 cycles of CIK cell infusion were performed for 5 patients,no adverse reaction was observed in these patients.The percentages of CD3 ＋,CD3 ＋ CD8 ＋ and CD3 ＋ CD56 ＋ increased significantly （P ＜ 0.05）,The therapy of CIK could significantly reduce the incidence of infection （P ＜ 0.05） and shorten the time of high fever in AML patients （P ＜ 0.05）.CIK also could reduce the volume of erythrocyte infusion to maintenance haematoglobin level（P ＜0.05）.We found that although CIK could not change the outcome of AML,the combination of CIK and chemotherapy could control patients＇condition and prolong their survival during the development and end stage of AML.It is concluded that autologous CIK cells combined with chemotherapy is safe and efficacious for the elderly patients with acute myeloid leukemia.