利妥昔单克隆抗体联合CIK治疗高龄眼眶弥漫大B细胞性淋巴瘤

高龄侵袭性弥漫大B细胞性非霍奇金淋巴瘤患者治疗存在一定难度。本研究探讨在利妥昔单克隆抗体单独或联合化疗的基础上,采用自体细胞因子诱导的杀伤细胞(CIK)治疗高龄眼眶弥漫大B细胞性淋巴瘤的疗效及安全性。1例89岁男性患者经右眼眶肿物部分切除术后病理诊断为弥漫大B细胞性非霍奇金淋巴瘤,在利妥昔单克隆抗体联合小剂量化疗治疗基础上,采用CIK细胞治疗5个疗程,每疗程输注(2-3)×109CIK细胞2次,同时给予rhIL-2 1 MU/d皮下注射,连续10 d,观察CIK细胞疗效及不良反应。结果显示:该患者的外周血单个核细胞能成功扩增出所需的CIK细胞,培养后的CIK细胞以CD3+和CD8+细胞为主,CD3+CD56+细胞得到大量扩增。CIK细胞治疗2个疗程后,原发眼眶淋巴瘤及左肾上极病变完全消失,5个疗程结束后患者达到完全缓解。CIK细胞治疗中未见到明显不良反应。结论:对于高龄眼眶淋巴瘤侵袭性较高、分期较晚的患者,在利妥昔单克隆抗体单独或联合小剂量化疗的基础上,采用自体CIK细胞治疗,可能更有助于预防肿瘤复发,延长无病生存期,改善患者生存质量。

Curative Efficiency of Rituximab Combined with Autologous Cytokine Induced Killer Cells on Aged Patient with Orbital Diffuse Large B Cell Lymphoma

The aim of this study was to observe the curative effects and safety of autologuous cytokine induced killer（CIK） cells in treatment of aged patients with orbital diffuse large B cell lymphoma after rituximab therapy.The patient was given rituximab three times with low dose COP chemotherapy one time when he was diagnosed with orbital diffuse large B cell lymphoma.Two months later,the patient began to receive five cycles CIK cells infusion.One course of therapy was defined as follows： about（2-3）×109 of CIK cells（survival rate95%） was transfused twice and then rhIL-2（1 MU daily） was subcutaneously administered for 10 consecutive days.Efficacy and adverse effect was ovserved during or after CIK cells infusion.The results showed that the peripheral blood mononuclear cells of the patient could be cultured and expanded into CIK cells.The majority of CIK cells was positive for CD3 and CD8 after culture.The CD3＋CD56＋ cells markedly increased after culture.After two cycles of CIK cell infusion,the orbital lymphoma and possible involvement of the kindey disappeared.The patient obtained complete remission after five cycles of CIK cells infusion.The side effects of CIK cell treatment were minor.It is concluded that CIK cell infusion may prevent recurrence,prolong progression-free survival and improve quality of life after rituximab（alone or with chemotherapy） for aged patients with orbital diffuse large B-cell lymphoma.