Usui A
Department of Urology, Hiroshima University School of Medicine.
Nihon Hinyokika Gakkai Zasshi. 1990 Jul;81(7):1058-64. doi: 10.5980/jpnjurol1989.81.1058.
The existence of immunosuppressive factors which impair the clinical effect of treatment using IL-2 or lymphokine activated killer (LAK) cells has been reported in the serum of patients with renal cell carcinoma. For the purpose of eliminating these immunosuppressive factors, plasmapheresis combined with adoptive immunotherapy using LAK cells was performed in ten patients with stage IV renal cell carcinoma. Immunological examinations revealed that the number of peripheral blood lymphocytes, NK activity and the ratio of Leu 11 positive cells were increased during the treatment. Of the 9 evaluable patients, one has a partial response, 5 showed no change and 3 had progressive disease. In addition to the one partial response, the size of some metastatic lesions in the lungs decreased in 2 patients during the treatment. As serious side effects, brain edema progressed in 2 patients with brain metastases and acute hepatitis due to plasmapheresis was noted in one patient. Moreover, transient and reversible renal dysfunction developed in most patients. These results indicated that plasmapheresis combined with adoptive immunotherapy using LAK cells is a useful therapy for patients with advanced renal cell carcinoma.
据报道，肾细胞癌患者血清中存在免疫抑制因子，这些因子会削弱使用白细胞介素-2或淋巴因子激活的杀伤细胞（LAK细胞）进行治疗的临床效果。为了消除这些免疫抑制因子，对10例IV期肾细胞癌患者进行了血浆置换联合LAK细胞过继免疫治疗。免疫学检查显示，治疗期间外周血淋巴细胞数量、自然杀伤细胞（NK）活性以及白细胞分化抗原11（Leu 11）阳性细胞比例均有所增加。在9例可评估的患者中，1例部分缓解，5例无变化，3例病情进展。除了1例部分缓解外，2例患者治疗期间肺部一些转移病灶的大小有所减小。作为严重的副作用，2例脑转移患者出现脑水肿进展，1例患者出现血浆置换所致的急性肝炎。此外，大多数患者出现了短暂且可逆的肾功能障碍。这些结果表明，血浆置换联合LAK细胞过继免疫治疗对晚期肾细胞癌患者是一种有效的治疗方法。
