自身细胞因子诱导的杀伤细胞过继性免疫治疗恶性肿瘤的临床观察

背景与目的:细胞因子诱导的杀伤细胞(CIK细胞)具有增殖快、杀瘤活性强和杀瘤谱广的特点。但用于临床肿瘤治疗的报告较少,本文旨在评估用CIK细胞过继回输治疗晚期肿瘤的疗效。方法:用淋巴细胞分离液分离患者末梢血单个核细胞,然后将末梢血单个核细胞加入含有IFN-γ、IL-2和CD3单抗的培养基中进行培养扩增,再将培养后的CIK细胞回输给病人;患者一个疗程接受CIK细胞总数在5×109～15×109之间。在CIK细胞治疗前有47例患者做了化疗,3例做了放疗。化放疗与CIK细胞治疗间隔时间在2～4周以上。结果:在63例接受治疗者中,部分缓解(PR)+微效(MR)为28例(44.46%)。20例CEA增高者,治疗后有14例减低,6例增加;10例AFP增高者,治疗后有9例减低,1例增加。CD3、CD4和CD8T淋巴细胞绝对值在CIK细胞治疗后均增加45%以上。治疗后63例中有51例患者有食欲增加、32例患者睡眠和体力改善,18例患者中有13例疼痛减轻,结论:用自身CIK细胞过继性回输治疗能明显提高癌症患者细胞免疫功能,改善临床体征,且无毒副作用。

Clinical observation on adoptive immunotherapy with autologous cytokine-induced killer cells for advanced malignant tumor

BACKGROUND & OBJECTIVE: Cytokine-induced killer (CIK) cells have the characteristics of rapid proliferation, high efficiency, and broad spectrum in killing of tumor cells. However, there was few report about its clinical application on treatment for cancer patients. The current study was designed to evaluate the effect of adoptive transfer of autologous CIK cells on the patients with advanced malignant tumor. METHODS: Peripheral blood mononuclear cells of the patients with advanced malignant tumor were separated by fractionation on Ficoll-Hypaque gradient, then cultured in the medium containing IFN-gamma, IL-2, and CD3McAb for 7 days in vitro, and than the cultured auto-CIK cells were transfused back to the patients. The numbers of transferred CIK cells per patient were 5-15 x 10(9) in one course of treatment. Among these patients, 47 cases received chemotherapy, 3 cases received radiotherapy before CIK cells transfusion. The interval between chemoradiotherapy and immunotherapy was over 2 to 4 weeks. RESULTS: Among 63 patients receiving CIK cells immunotherapy, the total effective rate (PR + MR) was 44.46% (28). In the patients with increasing of CEA level in serum, 14 cases showed reduction of serum CEA and 1 cases remained increasing after the treatment with CIK cell. In the patients with increasing of AFP level in serum, similarly, 9 cases showed reduction of serum AFD and 1 case remained increasing. The absolute members of CD3, CD4, and CD8T cells increased to over 45% after being treated with CIK cells. Among treated patients, the appetite of 51 cases and performance and sleep of 32 cases got improved. Among 18 cases, 13 cases showed the pain relief. CONCLUSION: Adoptive immunotherapy of auto-CIK cells can significantly enhance cellular immune functions and improve subjective symptoms, but without side effects, so this is a safe and effective treatment for the patients with malignant tumor.