DC、CIK治疗在急性白血病中的临床应用与疗效观察

【摘要】目的 通过体外培养获得树突状细胞（DC）和细胞因子诱导的杀伤细胞（CIK），应用于急性白血病（AL）患者体内白血病微小残留病（MRD）的清除，探讨其临床应用方法、疗程、安全性和疗效评估。方法 34例共45例次AL患者均通过血细胞单采获得外周血单个核细胞，以细胞因子体外诱导获得DC和CIK，分别行腹股沟淋巴结区皮下注射和静脉输注；治疗过程中观察不良反应及安全性；治疗前、中、后期进行T细胞亚群、细胞因子水平、肿瘤坏死因子、微小残留病灶、骨髓涂片和融合基因等方面检测，进行疗效评估。结果 DC、CIK治疗不良反应少，安全性好，偶见发热等症状，可自行消退；所有患者治疗结束后均处于血液学和遗传学缓解状态，T细胞亚群、细胞因子水平、肿瘤坏死因子和微小残留病灶检测取得满意结果。结论 DC、CIK治疗AL安全有效，副作用少，患者易于耐受，短期疗效肯定，为AL患者MRD的清除以至AL的治愈提供了一条新的有效途径，对其远期疗效需扩大例数进一步观察。 【关键词】 树突状细胞；细胞因子诱导的杀伤细胞；急性白血病；白血病残留病灶

Clinical and effectiveness analysis of dendritic cells and cytokine-induced killer cells therapy for acute leukemia.

ABSTRACT：Objective To investigate the methods, safety and influence on the immune function about the treatment of dendritic cells（DC）and cytokine-induced killer cells（CIK）cultured in vitro on acute leukemia(AL). Methods Mononuclear cells (MNCs) were isolated from peripheral blood from 34 AL patients and cultured in vitro in the presence of combined cytokines to generate DC and CIK. All patients were treated with the DC and CIK by subcutaneous injection and venous transfusion. Adverse effect and safety were observed after treatment. The change of T cells subsets, the secretion of cytokines, gamma-interferon, and tumor necrosis factor, minimal residual disease were determined before and after the treatment. Results All the patients have no significant adverse effect after the treatment and continue to keep up bone marrow complete remission. The level of CD3＋CD56＋ T cells, cytokines, gamma-interferon, and tumor necrosis factor enhances after the treatment. Conclusion The review has demonstrated that this treatment is feasible and safety in AL patients and holds promise as a possible new treatment for AL patients with minimal residual disease. 【Key words】 Dendritic cells；Cytokine-induced killer；Acute leukemia；Minimal residual disease