荷载自体白血病抗原的DC-CIK细胞预防急性髓细胞性白血病自体造血干细胞移植后复发的临床研究

目的探讨荷载自体白血病抗原的树突状细胞-细胞因子诱导的杀伤细胞(DC-CIK)细胞对于预防急性髓细胞性白血病(AML)自体造血干细胞移植后复发的作用。方法实验组:选取初治AML CR1期、自愿接受自体造血干细胞移植联合荷载自体白血病抗原的DC-CIK细胞治疗的患者32名,采用常规预处理方案,于移植+5—+10 d将荷载自体白血病抗原的DC-CIK细胞回输患者,采用流式细胞术、ELISA等方法测定DC-CIK细胞各指标情况;对照组:选取同期未采用DC-CIK细胞治疗的AML CR1期移植患者21名;观察、比较2组患者造血恢复情况、移植相关不良反应,评估3年总生存率。结果实验组患者CIK经荷载自体白血病抗原的DC致敏后,CD3+CD8+和CD3+CD56+细胞比例分别为(80.1±3.3)%和(37.1±4.5)%,较对照组[(56.1±3.8)%和(18.1±3.1)%]均有所上调(P<0.05),分泌IFN-γ的水平为(3 985.4±223.1)pg/ml,较对照组[(1 688.5±162.1)pg/ml]明显升高(P<0.05),除一过性发热、寒颤外,无其他不良反应。造血恢复情况、移植相关不良反应2组差异无统计学意义,自体造血干细胞移植后经DC-CIK细胞输注,3年的总生存率为75.0%(24/32),较同期未使用荷载白血病抗原DC-CIK细胞的自体造血干细胞移植患者的生存率明显提高。结论荷载自体白血病抗原的DC-CIK细胞用于预防AML自体造血干细胞移植后复发是安全和有效的。

Autologous leukemia antigen pulsed dendritic cell-cytokine induced killer cell in the prevention of acute myeloid leukemia relapse after autologous stem cell transplantation

Objective To investigate the effect of autologous leukemia antigen pulsed dendritic cell-cytokine induced killer cell(DC-CIK) in preventing acute myeloid leukemia(AML)relapse after autologous hematopoietic stem cell transplantation(AHSCT).Methods 32 AML patients in the 1st complete remission(CR1)who voluntarily received autologous leukemia antigen pulsed DC-CIK therapy after AHSCT were taken as the experimental group.Twenty one patients receiving AHSCT in the same period were taken as the control group.Conventional conditioning regimens were given to both groups.In the experimental group,DC-CIK were infused between 5—10 d after transplantation.Various indicators of DC-CIK cells were detected.Hematopoietic recovery and transplant-related adverse reactions were measured and 3-year overall survival was evaluated.Results In the experimental group,after sensitization by autologous leukemia antigen pulsed DC,the proportion of CD3+CD8+and CD3+CD56+ cells in CIK were(80.1±3.3)% and(37.1±4.5)% respectively,significantly higher than those of the control group[(56.1±3.8)% and(18.1±3.1)%,respectively](P<0.05),IFN-γ secretion was(3 985.4±223.1)pg/ml in the experimental group,significantly higher than the control group[(1 688.5±162.1)pg/ml](P<0.05).Except transient fever and chills,no other adverse reactions were observed.There was no significant difference between the two groups in hematopoietic recovery and transplant-related adverse reactions.Three year overall survival of AHSCT in AML was 75.0%(24/32)after DC-CIK treatment,which was improved significantly.Conclusion Autologous leukemia antigen pulsed DC-CIK is safe and effective for the prevention of AML relapse after AHSCT.