急性髓细胞白血病患者DC-CIK治疗后T细胞亚群动态变化的临床观察

目的观察急性髓细胞白血病患者经自体外周血移植联合自身白血病细胞冻融抗原负载的DC-CIK输注治疗后体内的T细胞亚群动态变化。方法选择50名初发急性髓细胞白血病患者,抽取其未缓解的骨髓制备自身白血病细胞冻融抗原,在自体外周血干细胞采集时分离部分单个核细胞培养DC-CIK,以自身白血病冻融抗原共培养激活扩增DC-CIK。患者自体外周血造血干细胞移植30～60 d输注自身白血病细胞冻融抗原负载的DC-CIK,每例每疗程回输细胞总数>7×109,同时给予IL-2(20 WU皮下注射,1次/d,连续10 d)皮下注射。动态观察患者接受DC-CIK细胞输注治疗后不同时间点体内T细胞亚群动态变化,并与既往接受自体外周血移植但未输注DC-CIK细胞治疗的52名急性髓细胞白血病患者进行比较分析。结果 50名患者DC-CIK输注后患者体内CD8+、CD16+、CD56+淋巴细胞均显著高于输注治疗前水平(P<0.01),治疗组同一随访时间段CD3+、CD4+、CD8+、CD16+、CD56+淋巴细胞均显著高于未采用DC-CIK治疗组(P<0.01)。结论对急性髓细胞白血病患者采用自体外周血移植联合自身白血病细胞冻融抗原负载的DC-CIK输注治疗,能显著提高患者肿瘤杀伤性T细胞水平,有助于清除移植后微小残留病,改善患者无病生存率(PFS)。

Changes of T lymphocyte subtypes in acute myeloid leukemia patients after auto-hematopoietic stem cell transplantation and treated with dendritic DC-CIK cells

Objective To observe the changes of T lymphocyte subtypes in acute myeloid leukemia patients after auto-hematopoietic stem cell transplantation(Auto-HSCT) and infusion of dendritic cells pulsed with frozen–thawed auto-leukemia cell lysates in combination with cytokine-induced killer cells(DC-CIK).Methods Fifty patients with acute myeloid leukemia were included in this clinical research.Before transplantation,bone marrow cells were collected for preparation of frozen–thawed auto-leukemia cell lysates,and mononuclear cells were collected during harvesting of peripheral hematopoietic stem cells.Dendritic cells were separated from mononuclear cells and pulsed with frozen–thawed auto-leukemia cell lysates and then co-cultured with mononuclear cells and cytokines to produce DC-CIK cells.Patients were infused with DC-CIK cells and IL-2 injection was given after hematopoietic reconstitution(between+30 d and +60d).Different subtypes of T lymphocytes(CD3+,CD4+,CD8+ and CD16+CD56+ T lymphocytes) were measured in these patients by flow cytometry.Results After treatment with DC-CIK cells,higher percentages of CD8+CD16+CD56+ lymphocytes were detected in patients,significantly higher than in patients without DC-CIK therapy(P<0.01).Conclusion Infusion of dendritic cells pulsed with frozen–thawed auto-leukemia cell lysates in combination with cytokine-induced killer cells(DC-CIK) can help promote CD8+ and CD16+CD56+ effector T lymphocytes,which may participate in eradicating minima residual disease(MRD) in acute myeloid leukemia after auto-hematopoietic stem cell transplantation(Auto-HSCT) and may improve progression free survival(PFS).