Yang Yang, Yang Bo, Cai Li-Li, Ran Hai-Hong, Yu Rui-Li, Chi Xiao-Hua, Zhu Hong-Li, Li Su-Xia, Liu Yang, Wang Yao, Han Wei-Dong, Yao Shan-Qian, Lu Xue-Chun
Department of Geriatric Hematology, Chinese PLA General Hospital, Beijing 100853, China.
Department of Geriatric Laboratorial Medicine, Chinese PLA General Hospital, Beijing 100853, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2014 Feb;22(1):58-63. doi: 10.7534/j.issn.1009-2137.2014.01.013.
This study was purposed to evaluate the effectiveness and safety of autologous cytokine induced killer (CIK) cells combined with chemotherapy in treatment of elderly patients with acute myeloid leukemia. Peripheral blood mononuclear cells (PBMNC) were isolated from 5 elderly patients with acute myeloid leukemia, and then augmented by priming with interferon gamma (IFN-γ) followed by IL-2 and monoclonal antibody (mAb) against CD3. The autologous CIK cells thus obtained were infused back to individual patients, 28 days as one cycle. The changes in cellular immune function, incidence of infection, independence of hematoglobin or blood transfusion, and progression of disease were observed and assessed before and after therapy. The results showed that the 46 cycles of CIK cell infusion were performed for 5 patients, no adverse reaction was observed in these patients. The percentages of CD3(+), CD3(+)CD8(+) and CD3(+)CD56(+) increased significantly (P < 0.05), The therapy of CIK could significantly reduce the incidence of infection (P < 0.05) and shorten the time of high fever in AML patients (P < 0.05). CIK also could reduce the volume of erythrocyte infusion to maintenance hematoglobin level (P < 0.05). We found that although CIK could not change the outcome of AML, the combination of CIK and chemotherapy could control patients' condition and prolong their survival during the development and end stage of AML. It is concluded that autologous CIK cells combined with chemotherapy is safe and efficacious for the elderly patients with acute myeloid leukemia.
本研究旨在评估自体细胞因子诱导杀伤（CIK）细胞联合化疗治疗老年急性髓系白血病患者的有效性和安全性。从5例老年急性髓系白血病患者中分离出外周血单个核细胞（PBMNC），先用γ干扰素（IFN-γ）致敏，然后用白细胞介素-2（IL-2）和抗CD3单克隆抗体（mAb）进行扩增。将由此获得的自体CIK细胞回输至各患者体内，以28天为一个周期。观察并评估治疗前后细胞免疫功能的变化、感染发生率、血红蛋白或输血独立性以及疾病进展情况。结果显示，对5例患者进行了46个周期的CIK细胞输注，这些患者均未观察到不良反应。CD3(+)、CD3(+)CD8(+)和CD3(+)CD56(+)的百分比显著增加（P<0.05），CIK治疗可显著降低感染发生率（P<0.05），并缩短急性髓系白血病患者高热持续时间（P<0.05）。CIK还可减少维持血红蛋白水平所需的红细胞输注量（P<0.05）。我们发现，虽然CIK不能改变急性髓系白血病的预后，但CIK与化疗联合应用可在急性髓系白血病的进展期和终末期控制患者病情并延长其生存期。结论是，自体CIK细胞联合化疗对老年急性髓系白血病患者安全有效。
