DC-CIK方案治疗41例急性白血病清除微小残留病变的疗效

目的：分析41例急性白血病微小残留病变的DC-CIK细胞治疗前后实验室检测指标改变特点，探讨其临床治疗意义。方法33例急性髓细胞白血病（ AML）患者均经MA方案（米托蒽醌、阿糖胞苷200 mg）或维甲酸/三氧化二砷诱导缓解，2例M2患者采用CAG方案（阿克拉霉素，阿糖胞苷，粒系集落刺激因子300μg/d）诱导缓解，8例急性淋巴细胞白血病患者均经VDCLP方案（长春新碱，柔红霉素，环磷酰胺，左旋门冬酰胺酶，泼尼松）诱导缓解。所有患者应用大剂量强化化疗方案缓解后用 DC-CIK交替维持治疗。结果 DC-CIK治疗后CD3^＋、CD3^＋CD8^＋、CD3^＋CD56^＋/CD16^＋细胞比例明显提高，差异有统计学意义。治疗后白细胞介素（ IL）-2、IL-12、IL-17、肿瘤坏死因子-α、干扰素-γ水平提高，而IL-8水平降低，差异有统计学意义。治疗前后微小残留灶WT1的检测显示3例AML 患者治疗前WT1阳性，经DC-CIK 治疗后转阴。IL-17健康对照组最高，未缓解及初治白血病最低，缓解组逐渐升高，DC-CIK治疗后接近正常。结论 DC-CIK免疫治疗急性白血病清除微小残留病变能改善患者免疫抑制状态，提高机体的抗急性白血病免疫效应，有较好的临床疗效。

Effect of DC-CIK regimen on minimal residual disease clearance of 41 patients with acute leuke-mia

Objective To analyze the change characteristics of laboratory test indexes before and after treatment with DC-CIK cells for 41 cases of acute leukemia minimal residual disease,and investigate its clinical significance. Methods Thirty-three cases of AML were treated with MA regimen（ 200 mg mitoxantrone,Ara）remission induced by arsenic trioxide or retinoic acid,2 cases of M2 were treated with CAG scheme（ Accra mycin,cytarabine,granulocyte colony-stimulating factor 300 μg/d）induction of remission,8 cases were treated with VDCLP regimen（ vincristine,doxorubicin,cyclophosphamide, prednisone,L-asparaginase,）induced remission. All patients had remission with large dose of intensive chemotherapy,and then with DC-CIK alternating maintenance treatment. Results After DC-CIK treat-ment,the CD3^＋CD3^＋CD8^＋CD3^＋CD56^＋CD16^＋cell ratio significantly increased,the differences were significant. The levels of IL-2,IL-12,IL-17,TNF-α,IFN-γlevels increased after treatment,and the level of IL-8 decreased,there were significant differences. Detection of minimal residual foci of WT1 showed positive WT1 in 3 cases of AML patients before treatment. After treatment of DC and CIK, showed negative WT1. IL-17 level in healthy control group was the highest,and the lowest in patients with initial treatment and without remission leukemia,in remission group,IL-17 level gradually in-creased,after the treatment with DC-CIK,returned to normal range. Conclusions DC-CIK immune therapy in treatment of acute leukemia minimal residual disease can improve the removal of immunosup-pression in patients with acute leukemia,and improve the immunity,has good clinical curative effect.