Chang Cheng, Yang Bo, Zhang Lin, Zhu Hong-Li, Lu Xue-Chun, Guo Bo, Cai Li-Li, Han Wei-Dong, Wang Yao, Fan Hui, Li Su-Xia, Liu Yang, Yang Yang, Zhai Bing, Ran Hai-Hong, Lin Jie, Zhang Feng
Department of Geriatric Hematology, Chinese PLA General Hospital, Beijing, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2013 Feb;21(1):62-7. doi: 10.7534/j.issn.1009-2137.2013.01.014.
This study was aimed to evaluate the effectiveness and safety of low methylation drug decitabine combined with autologous cytokine induced killer cells (CIK) to treat the elderly patients with acute myeloid leukemia (AML). Two AML patients aged over 80 years old were diagnosed and treated in our department from 2006 to 2012; both company with MDS history, and one case was M4-type, another case was M6-type according to FAB classification. The changes in lymphocyte subsets, hematologic response, transfusion frequency, leukemic gene expression, obtaining CR or PR, quality of life and survival time of the patients with different treatment regimen (decitabine alone; CIK alone; decitabine combined with CIK) were systematically observed. The results showed that therapy of decitabine combined with CIK cells could reduce bone marrow suppression extent, decrease the frequency and volume of blood transfusion, and prolong the duration of partial remission, compared with the single use of CIK cell infusion and single use of decitabine treatment. Meanwhile, the kinds of expressed genes associated with leukemia decreased and the survival time was prolonged obviously. The patients' life quality significantly improved. It is concluded that decitabine combined with CIK for treatment of elderly patients with AML is safe and effective.
本研究旨在评估低甲基化药物地西他滨联合自体细胞因子诱导杀伤细胞(CIK)治疗老年急性髓系白血病(AML)患者的有效性和安全性。2006年至2012年,我科诊断并治疗了2例80岁以上的AML患者;二者均有骨髓增生异常综合征(MDS)病史,根据FAB分类,1例为M4型,另1例为M6型。系统观察了不同治疗方案(单独使用地西他滨;单独使用CIK;地西他滨联合CIK)患者的淋巴细胞亚群变化、血液学反应、输血频率、白血病基因表达、获得完全缓解(CR)或部分缓解(PR)情况、生活质量和生存时间。结果显示,与单独使用CIK细胞输注和单独使用地西他滨治疗相比,地西他滨联合CIK细胞治疗可减轻骨髓抑制程度,减少输血频率和输血量,并延长部分缓解持续时间。同时,与白血病相关的表达基因种类减少,生存时间明显延长。患者生活质量显著改善。结论是,地西他滨联合CIK治疗老年AML患者安全有效。