含胸腺肽免疫增强的自体CIK细胞联合IL-2方案治疗高龄弥漫大B细胞淋巴瘤

目的评价含胸腺肽免疫增强的自体CIK细胞联合IL-2(TCIL-2)方案治疗高龄弥漫大B细胞淋巴瘤的有效性和安全性。方法采集预先接受胸腺五肽免疫增强治疗的4例高龄弥漫大B细胞淋巴瘤(DLBCL)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,回输细胞数为2×109-3×109个,回输后应用IL-2 100mU/d,皮下注射,连续10d。28d为1个周期,共完成24个周期的自体CIK细胞输注。观察治疗前后细胞免疫功能、肿瘤相关生物学指标变化。结果 2例接受8个周期的CIK细胞输注,2例接受4个周期的输注,回输后所有患者未出现不良反应。CIK细胞治疗后CD3+、CD3+CD8+、CD3+CD56+细胞比例明显升高(P<0.05),β2微球蛋白水平显著下降(P<0.05)。3例达完全缓解,1例完成8周期的CIK细胞输注后一度达良好的部分缓解,但最终因急性心肌梗死和淋巴瘤持续进展而死亡。结论自体CIK细胞联合IL-2治疗高龄弥漫大B细胞淋巴瘤安全有效。

Treatment of diffuse large B cell lymphoma with combined thymic peptide-enhanced autologous cytokine induced killer cells and IL-2 in aged patients

Objective To assess the efficiency and safety of combined thymic peptide-enhanced autologous cytokine induced killer(CIK) cells and IL-2 in treatment of diffuse large B cell lymphoma in aged patients.Methods Peripheral blood mononuclear cells(PBMC) were collected from 4 aged patients with diffuse large B cell lymphoma.CIK cells were induced with in vitro interferon gamma(IFN-γ),IL-2 and anti-CD3 monoclonal antibody(mAb).Immune function of the cells and tumor-related biological indexes of the patients were observed after 2×109-3×109 autologous CIK cells were re-transfused into the patients each time and IL-2 100mU/d was subcutaneously injected for 10 days,28 days a cycle for 24 cycles.Results Two patients received 8 cycles of CIK cells transfusion and 2 patients received 4 cycles of CIK cells transfusion.No adverse reaction occurred in them.The number of CD3+,CD3+CD8+ and CD3+CD56+ was significantly greater and the serum β2-microglobulin level was markedly lower after CIK cells transfusion than before CIK cells transfusion(P<0.05).Complete remission was achieved in 3 patients and 1 patient died of acute large-area myocardial infarction and persistent progression of lymphoma although partial remission was achieved after 8 cycles of CIK cells transfusion.Conclusion Combined autologous CIK cells transfusion and IL-2 is safe and effective for large B cell lymphoma in aged patients.