Maki G
Section of Bone Marrow Transplant and Cell Therapy, Rush Presbyterian-St. Luke's Medical Center, Rush Medical School, Rush University, Chicago, IL 60612, USA.
J Hematother Stem Cell Res. 2001 Aug;10(4):545-51. doi: 10.1089/15258160152509154.
Autologous stem cell transplantation (SCT) is the treatment alternative offered to patients that cannot benefit from allogeneic transplantation due to lack of suitable donor or age limitations. However, the outcome of autologous SCT is largely hindered by the high relapse rate. Two major factors can account for relapse after autologous SCT: the persistence of residual malignant cells resistant to chemo/radiotherapy left either in the body or in the autograft. Therefore, the rationale for purging autografts of residual malignant cells comes from the limitations of conventional high-dose chemo/radiotherapy in achieving a complete eradication of residual tumor cells in the marrow. To date, different purging modalities have been exploited. Immunological methods of purging present the advantage of being non-cross-reactive with conventional chemotherapy. These immunologic methods include depletion using antibody targeting of the malignant cells, ex vivo activation/generation of the autologous cytotoxic cells, in particular that of natural killer/lymphokine-activated killer (NK/LAK) and cytokine-induced killer (CIK) cells, and ex vivo purging of autografts using cytotoxic cell lines. The generation of ex vivo-expanded and activated autologous cytotoxic cells (CTL or NK) has generated increasing interest for the treatment of different malignancies. Unfortunately, the isolation and expansion of these cells have proven to be technically difficult. As an alternative, the use of cytotoxic cell lines as immune effectors has been proposed. The two available human cytotoxic cell lines TALL104 and NK-92 are currently in clinical trials and a number of studies have suggested their effectiveness as an immunotherapeutic agent including for ex vivo purging of autografts.
自体干细胞移植（SCT）是为那些因缺乏合适供体或年龄限制而无法从异基因移植中获益的患者提供的治疗选择。然而，自体SCT的结果在很大程度上受到高复发率的阻碍。自体SCT后复发可归因于两个主要因素：体内或自体移植物中存在对化疗/放疗耐药的残留恶性细胞。因此，清除自体移植物中残留恶性细胞的基本原理源于传统高剂量化疗/放疗在彻底清除骨髓中残留肿瘤细胞方面的局限性。迄今为止，已采用了不同的清除方式。免疫清除方法具有与传统化疗无交叉反应的优点。这些免疫方法包括使用针对恶性细胞的抗体进行清除、体外激活/生成自体细胞毒性细胞，特别是自然杀伤细胞/淋巴因子激活的杀伤细胞（NK/LAK）和细胞因子诱导的杀伤细胞（CIK），以及使用细胞毒性细胞系对自体移植物进行体外清除。体外扩增和激活自体细胞毒性细胞（CTL或NK）的产生已引起人们对治疗不同恶性肿瘤的越来越多的关注。不幸的是，事实证明这些细胞的分离和扩增在技术上很困难。作为一种替代方法，有人提出使用细胞毒性细胞系作为免疫效应器。现有的两种人类细胞毒性细胞系TALL104和NK - 92目前正在进行临床试验，许多研究表明它们作为免疫治疗剂的有效性，包括用于自体移植物的体外清除。
