Ahlberg Richard, MacNamara Barbara, Andersson Margareta, Zheng Chengyun, Svensson Anna, Holm Göran, Hansson Mona, Porwit-MacDonald Anna, Björkholm Magnus, Sundblad Anne
Division of Hematology, Department of Medicine, Karolinska Hospital and Institutet, Stockholm, Sweden.
Hematol J. 2003;4(5):336-41. doi: 10.1038/sj.thj.6200320.
Limited therapeutic options remain for patients with relapsing lymphoma following chemotherapy and autologous stem cell transplantation (ASCT), hence motivating investigations of complementary treatments. The aim of the present study was to evaluate feasibility and immunological effects of an immunotherapy schedule administered during chemotherapy-induced remission of aggressive non-Hodgkińs lymphoma (NHL). Repeated cycles of rIL-2, rIFN-alpha and histamine were administered to a patient with a grade III follicle center cell lymphoma, following relapse and high-dose chemotherapy with stem cell support. T-cell cytokine production and repertoire alterations were monitored by flow cytometry together with assessment of natural killer (NK) cell-mediated cytotoxicity. The treatment schedule induced significant increases in frequencies of CD4+ T cells expressing intracellular IFN-gamma or IL-4, thus a T helper (Th) 1 and Th 2 type of response were observed. CD8+T cells showed enhancement mainly of TNF-alpha production. Such induction of T-cell effector functions was accompanied by an augmentation of NK-cell cytotoxicity and a pronounced reduction of possibly regulatory CD57 expressing lymphocytes. The results indicate synergistic T- and NK-cell activation by tolerable doses of the combined immunotherapy, administered during remission after chemotherapy and ASCT in NHL.
对于化疗和自体干细胞移植(ASCT)后复发的淋巴瘤患者,可用的治疗选择有限,因此激发了对补充治疗方法的研究。本研究的目的是评估在侵袭性非霍奇金淋巴瘤(NHL)化疗诱导缓解期间给予免疫治疗方案的可行性和免疫效果。在一名III级滤泡中心细胞淋巴瘤患者复发并接受高剂量化疗及干细胞支持后,给予其重复周期的重组白细胞介素-2(rIL-2)、重组干扰素-α(rIFN-α)和组胺。通过流式细胞术监测T细胞细胞因子产生和谱系改变,并评估自然杀伤(NK)细胞介导的细胞毒性。该治疗方案使表达细胞内干扰素-γ或白细胞介素-4 的CD4 + T细胞频率显著增加,因此观察到了辅助性T细胞(Th)1和Th2型反应。CD8 + T细胞主要表现为肿瘤坏死因子-α产生增强。T细胞效应功能的这种诱导伴随着NK细胞细胞毒性的增强以及可能表达调节性CD57的淋巴细胞的显著减少。结果表明,在NHL化疗和ASCT后的缓解期给予可耐受剂量的联合免疫治疗可协同激活T细胞和NK细胞。