化疗联合自体细胞因子诱导杀伤细胞治疗急性白血病的临床观察

目的评价化疗联合自体细胞因子诱导的杀伤细胞(CIK)治疗急性白血病(AL)的疗效。方法选择经化疗达完全缓解(CR)>6个月的AL患者41例。19例患者接受化疗联合自体CIK细胞治疗,22例接受同期单纯化疗作为对照组。CIK细胞治疗采用血细胞分离机大量采集患者的外周血单个核细胞,用抗CD3单抗、IL2、IFNγ培养10d,将细胞洗涤后经静脉于化疗后第一天回输给患者。结果CIK组19例患者化疗同时共接受52疗程CIK细胞治疗,每例患者平均接受2~3个疗程CIK细胞治疗。每疗程回输CIK细胞总数为(22~300)×109/L,平均(142±85)×109/L。4年持续CR(CCR)率CIK组为734%;单纯化疗组4年预期CCR率为273%。两者差异有统计学意义(P<0005)。接受≥3个疗程CIK治疗的10例患者至观察截止时均处于CCR,中位CCR期43个月(23~52个月);接受<3个疗程CIK治疗的患者4/9例复发。结论化疗联合自体CIK细胞治疗AL的CCR率明显优于单纯化疗;疗效与疗程有关,疗程≥3个患者的疗效优于疗程<3个的患者。

The efficacy of chemotherapy in combination with auto-cytokine-induced killer cells in acute leukemia

OBJECTIVE: To evaluate the efficacy of chemotherapy in combination with autologous cytokine induced killer cells for the treatment of acute leukemia. METHODS: 41 patients with acute leukemia were evaluated; complete remission was achieved in these patients for more than 6 months duration after chemotherapy. 19 patients who received autologous cytokine induced killer (CIK) cells followed by chemotherapy constituted a CIK group and 22 patients who received the same term of chemotherapy only constituted a control group. Preparation of CIK cells was as follows: Peripheral blood mononuclear cells from the patient were collected by using blood cell separator, then cultured in the medium containing monoclonal antibody against CD(3), interleukin-2 and interferon gamma for about 10 days, and finally infused back to the patient on the first day after chemotherapy. The programs of chemotherapy in the two groups were similar. RESULTS: 19 patients in the CIK group received a total of 52 courses of CIK cells. 8 patients received 4 courses, 2 patients 3 courses, 5 patients 2 courses and 4 patients one course of treatment. The numbers of transfused CIK cells per patient were (14.2 +/- 8.5) x 10(9)/L; (2.2 approximately 30.0) x 10(9)/L (Mean +/- s; range) in one course of treatment. Continuous complete remission (CCR) rate was 73.4% in the CIK group versus 27.3% in the control group in a follow up of 4 years (P < 0.005). ALL patients who received >or= 3 courses of treatment in the CIK group have remained in CCR till the time of this study; the median time of CCR were 43 months (23 - 52 months). 4 of the 9 patients who received < 3 courses of CIK treatment relapsed after CR by 43, 17, 13 and 9 months respectively. CONCLUSIONS: CCR rate was higher in patients with chemotherapy plus CIK cells for acute leukemia than in patients with chemotherapy alone. In the CIK group; the efficacy of therapy patients who received >or= 3 courses of treatment was better than that in patients who received < 3 courses of treatment.