体外培养DC-CIK细胞过继免疫治疗恶性肿瘤的护理

[目的]总结体外培养树突状细胞调节和细胞因子诱导的杀伤细胞（DC-CIK）过继免疫治疗恶性肿瘤的护理措施。[方法]对12例恶性肿瘤病人行DC-CIK细胞过继免疫治疗,同时加强心理护理、不良反应的预防及护理等。[结果]12例病人均顺利完成DC-CIK细胞过继免疫治疗,5例病人出现寒战、发热,1例出现皮肤瘙痒、皮疹,经处理均好转。[结论]加强恶性肿瘤病人行DC-CIK细胞过继免疫治疗的护理是治疗成功的关键。     

DC-CIK细胞过继免疫治疗肿瘤患者的护理进展

DC-CIK生物免疫治疗是继手术、放射治疗、化疗之后肿瘤患者可选择的第四大治疗模式。DC-CIK是肿瘤免疫治疗的两个重要部分。前者DC细胞,又称树突状细胞(den-dritic cells,DC),是体内摄取、加工,呈送抗原的最重要的专职抗原呈递细胞,它呈递抗原的能力最强,是巨噬细胞的10～100倍,且是唯一可以活化初始T细胞的抗原呈递细胞。CIK细胞,即细胞因子诱导的杀伤细胞,是外周淋巴细胞在体外经     

肾癌根治术后及免疫治疗护理

目的 探讨肾癌根治术后及免疫治疗中护理的应用.方法 对36例肾癌患者行根治术后及免疫治疗的临床护理实践进行总结.结果 临床护理措施的目的 性和有效性得到提高.结论 及时、合理、有效的护理能促进患者早日康复,提高患者生活质量,延长患者生存时限.     

肾癌根治术后及免疫治疗护理

目的探讨肾癌根治术后及免疫治疗中护理的应用。方法对36例肾癌患者行根治术后及免疫治疗的临床护理实践进行总结。结果临床护理措施的目的性和有效性得到提高。结论及时、合理、有效的护理能促进患者早日康复,提高患者生活质量,延长患者生存时限。     

肺癌病人CIK细胞过继免疫治疗的护理

目的 探讨中晚期肺癌病人应用细胞因子诱导的杀伤细胞(CIK)治疗的护理规范.方法 回顾性总结2009年9月～2010年10月接受CIK细胞过继免疫治疗139例肺癌病人从护患沟通、心理护理、标本采集、CIK细胞悬液回输和输注后病情观查等环节的经验.结果 139例中晚期肺癌患者接受CIK细胞过继免疫治疗后有1例出现发热,其...     

DC-CIK细胞过继免疫治疗病人的护理

恶性肿瘤是危害人类健康的疾病之一,死亡率居第2位.1985年美国国家癌症中心把生物治疗列为肿瘤综合治疗的第4种模式,作为手术、放疗、化疗3大常规模式的有益补充.     

自体DC-CIK细胞免疫治疗恶性肿瘤60例临床护理

应用DC-CIK的过继细胞免疫治疗在临床中得到证实,治疗采用患者自身诱导、激活自体细胞,调动人体的天然抗癌能力,相对安全,无毒副作用,容易被患者接受。DC是迄今为止发现的功能最强大的抗原递呈细胞,即把肿瘤的相关抗原信息传递给人体内正常的具有杀伤活性的细胞。CIK是人     

癌症患者DC-CIK 细胞共培养免疫治疗的护理干预

目的：探讨癌症患者接受DC‐CIK细胞共培养免疫治疗的护理干预效果。方法对15例癌症患者在接受DC‐CIK细胞共培养免疫治疗中做好心理护理,严格无菌操作,静脉滴注DC‐CIK细胞前后用生理盐水冲管,预防不良反应发生。结果本组7例患者生活质量明显提高,4例患者临床症状未见明显改善,4例患者出现低热。结论做好心理护理、严格无菌操作及静脉滴注DC‐CIK细胞前后用生理盐水冲管是保证CIK细胞数量和质量的关键,也是治疗成功的保证。     

自体CIK细胞免疫治疗16例护理干预

对16例患者采用自体CIK细胞体内回输治疗,并给予有针对性的护理干预.结果11例慢性乙肝患者有9例治疗已达到20周,病毒学指标有明显下降趋势;5例肿瘤患者中有4例一般状况评分和生活质量评分有明显提高.认为在治疗过程中,做好采血前、采血中、采血后及回输的护理,并加强对其不良反应的观察与处理,保证了治疗的成功.     

肾移植术后并发自体泌尿系统移行细胞癌患者的护理

目的探讨肾移植术后并发自体肿瘤的护理方法。方法总结对患者的心理、治疗、并发症观察等方面的护理经验。结果9例患者术后均恢复良好,无并发症出现。结论正确系统的护理措施对患者的顺利恢复具有重要的作用。     

自身抗原激活的树突状细胞联合细胞因子诱导杀伤细胞过继免疫治疗晚期前列腺癌的临床研究

目的 探讨自身癌细胞抗原(Ag)激活的树突状细胞(DC)联合细胞园子诱导杀伤细胞(CIK)在晚期前列腺癌免疫治疗中的临床疗效.方法 回顾性研究48例诊断明确且不再适宜手术或放化疗的晚期激素难治性前列腺癌(HRPC)患者,配对分成两组:对照组24例,接受内科保守治疗;免疫组24例,同时给予内科治疗和Ag-DC-CIK过继...     

细胞因子诱导的杀伤细胞应用于中晚期肾癌患者的护理

目的:评价细胞因子诱导的杀伤细胞应用于中晚期肾癌患者中的护理。方法:收集2009年10月～2011年10月我科收治的51例中晚期肾癌患者,对其治疗期间的健康宣教、抽血护理、心理护理、回输前后护理、不良反应观察及预防等方面进行回顾性分析。结果:本组51例患者中完全缓解0例,部分缓解11例,稳定27例,进展13例。其中1例发生高热(39℃以上),经口服吲哚美辛片25 mg后体温恢复正常;13例发生低热(37.6～38.5℃),未经特殊处理,自行好转。结论:接受细胞因子诱导的杀伤细胞治疗中晚期肾癌患者经合理而恰当的护理对患者的治疗有一定影响,值得临床推广应用。     

自体CIK细胞输注治疗老年骨髓增生异常综合征的临床研究

本研究旨在评价自体细胞因子诱导的杀伤细胞(cytokine-induced killer cells,CIK)治疗老年骨髓增生异常综合征(myelodysplastic syndromes,MDS)的安全性和有效性。采集6例老年MDS患者外周血单个核细胞,在体外经细胞刺激因子培养,诱导成CIK细胞,回输至患者体内,28天为1个疗程。观察CIK细胞回输后患者体内效应细胞的比例变化、不良反应以及对感染的发生、血红蛋白水平和对输血依赖程度的影响。结果表明,经CIK细胞治疗后CD3+、CD3+CD8+、CD3+CD56+细胞比例明显升高(p<0.05),所有患者未出现严重不良反应。CIK细胞治疗有效地减少了MDS患者感染的发生,缩短了高热时间。在疾病稳定期,CIK细胞输注可减少红细胞的输注量,稳定血红蛋白水平,但不能改变MDS向高危亚型转化的自然病程。结论 :自体CIK细胞输注治疗老年人MDS安全有效。     

Cytokine-induced killer (CIK) cells as feasible and effective adoptive immunotherapy for the treatment of solid tumors

Introduction: Cytokine-induced killer (CIK) cells are heterogeneous ex vivo-expanded T lymphocytes with mixed T-NK phenotype and endowed with a wide MHC-unrestricted antitumor activity. CIK cells can be expanded from peripheral blood mononuclear cells (PBMC) cultured with the timed addition of IFN-γ, Ab anti-CD3 and IL2. A consistent subset of mature CIK cells presents a CD3⁺CD56⁺ phenotype. The CD3⁺CD56⁺ cellular subset is the main responsible for the tumor-killing activity, mostly mediated by the interaction of NKG2D receptor with MHC-unrestricted ligands (MIC A/B; ULBPs) on tumor cells.

Areas covered: In the present work, we described the biologic characteristics of CIK cells, focusing on those aspects that may favor their clinical translation. We reviewed preclinical data and analyzed reports from clinical trials. A specific paragraph is dedicated to future research perspectives in the field.

Expert opinion: CIK cells represent a realistic new option in the field of cancer immunotherapy. Crucial issues, favoring their clinical translation, are the easy availability of large amounts of expanded CIK cells and their MHC-unrestricted tumor killing, potentially effective against many tumor types. Intriguing future perspectives and open challenges are the investigation of synergisms with other immunotherapy approaches, targeted therapies or even conventional chemotherapy.     

Novel immune‐related signature based on immune cells for predicting prognosis and immunotherapy response in clear cell renal cell carcinoma

BackgroundClear cell renal cell carcinoma (ccRCC) is the most common malignant tumor of the kidney and is characterized by poor prognosis. We sought to build an immune‐related prognostic signature and investigate its relationship with immunotherapy response in ccRCC.MethodsImmune‐related genes were identified by ssGSEA and WGCNA. The prognostic signature was conducted via univariate, least absolute shrinkage and selection operator, and multivariable Cox regression analyses. Kaplan‐Meier analysis, PCA, t‐SNE, and ROC were used to evaluate the risk model.ResultsA total of 119 immune‐related genes associated with prognosis were screened out. Six immune‐related genes (CSF1, CD5L, AIM2, TIMP3, IRF6, and HHLA2) were applied to construct a prognostic signature for KIRC. Kaplan–Meier analysis showed that patients in high‐risk group had a poorer survival outcome than in low‐risk group. The 1‐, 3‐ and 5‐year AUC of the prognostic signature was 0.754, 0.715, and 0.739, respectively. Univariate and multivariate Cox regression models demonstrated that the risk signature was an independent prognostic factor for KIRC survival. GSEA analysis suggested that the high‐risk group was concentrated on immune‐related pathways. The high‐risk group with more regulatory T‐cell infiltration showed a higher expression of immune negative regulation genes. The risk score had positively relationship with TIDE score and negatively with the response of immunotherapy. The IC50 values of axitinib, sunitinib, sorafenib, and temsirolimus were lower in the high‐risk group.ConclusionOur study defined a robust signature that may be promising for predicting clinical outcomes and immunotherapy and targeted therapy response in ccRCC patients.     

自体CIK过继免疫治疗恶性肿瘤的最佳输注时间

摘要：目的:研究恶性肿瘤患者自体细胞因子诱导的杀伤细胞(CIK)的免疫表型与细胞毒活性的变化规律,探讨肿瘤患者CIK过继免疫治疗输注的最佳时间。 方法:采集40例恶性肿瘤患者外周血单个核细胞(PBMC),由IFN-γ、rhIL-1α、rhIL-2等细胞因子和CD3单克隆抗体体外诱导培养成CIK。用流式细胞术动态监测免疫表型,MTT法分析细胞毒活性。 结果：随着诱导时间的延长,PBMC中CD3⁺、CD3⁺CD8⁺、CD3⁺CD56⁺表型细胞所占比例呈上升趋势。CD3⁺CD4⁺细胞在7 d达到峰值,随后缓慢下降。CD25⁺细胞在培养的早期(3～7 d)即达峰值,7～14 d缓慢下降,14～21 d快速下降。HLA-DR+细胞在0～14 d处于上升期,14 d达峰值后快速下降。成熟CIK细胞毒活性［(52.49±7.70)%］较未活化的PBMC［(7.02±2.00)%］显著增高(P<0.01)。 结论:14 d左右能诱导出典型的CIK,CD3⁺CD56⁺细胞处于对数生长期。确立自体CIK过继免疫治疗恶性肿瘤的最佳输注时间为第14天。     

Immunotherapy using autologous monocyte-derived dendritic cells pulsed with leukemic cell lysates for acute myeloid leukemia relapse after autologous peripheral blood stem cell transplantation

Although a second stem cell transplantation (SCT) can be used as salvage therapy in patients with relapsing leukemia after SCT, most of these patients have a poor outcome. We tried clinical vaccination using monocyte-derived dendritic cells (DCs) pulsed with leukemic lysates to treat relapsing acute myeloid leukemia (AML) after autologous SCT. To generate DCs, CD14+ cells isolated from peripheral blood stem cell products were cultured in AIM-V in the presence of GM-CSF and IL-4. Adding TNF-alpha on day 6 induced maturation of the DCs, which were harvested on day 8 or 9. The DCs were incubated with tumor lysate and KLH for 2 hr at 37 degrees C. After certifying the absence of microorganisms and endotoxins, the patients received four DC vaccinations at two- to three-week intervals. Two patients received four DC vaccinations with means of 7.8 x 10(6) and 9 x 10(6) DCs at two- to three-week intervals. The DC vaccinations were well tolerated with no apparent side effects. After the vaccinations, the patients showed immunological responses with positive delayed-type hypersensitivity skin reaction and increasing autologous T cells stimulatory capacity to the DCs; however, the BM blast percentage of the patients did not improve. The results suggest that DCs are a feasible cellular therapy for relapsing AML after autologous SCT.     

DC-CIK联合化疗对晚期肾癌患者外周血中微转移表达的影响

目的:检测转移性肾细胞癌(mRCC)患者DC-CIK联合化疗前后外周血中G250 mRNA表达的变化,探讨其与生物化学治疗疗效的相关性.方法:31例mRCC患者首先经实时定量逆转录-聚合酶链反应(real-time quantitative RT-PCR,qRT-PCR)检测外周血G250 mRNA为阳性表达,予2周期的DC+CIK联合化疗后,再次检测外周血中G250 mRNA阳性表达情况,并评价DC-CIK联合化疗对肿瘤的疗效.结果:生物化学治疗后31例G250 mRNA阳性的患者外周血中18例(58.1％)表达下降,5例(16.1％)无明显变化,8例(25.8％)表达水平呈上升,与化疗前相比差异有统计学意义(P＜0.01);治疗后,11例部分缓解(PR)(35.5％),9例稳定(SD)(29.0％)、11例进展(PD) (35.5％);mRCC患者外周血中G250 mRNA表达变化与生物化疗疗效显著相关(r=0.498).结论:检测mRCC患者外周血中G250 mRNA变化可用于评价生物化疗的疗效.