Zhou Min, Wang Jing, Li Cui-Ping, Xu Jing-Yan, Chen Bing
Department of Hematology, The Affiliated DrumTower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, People's Republic of China.
Department of Transfusion, BenQ Medical Center, Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China.
Onco Targets Ther. 2020 Jun 22;13:5879-5885. doi: 10.2147/OTT.S254291. eCollection 2020.
To evaluate whether autologous cytokine-induced killer (CIK) cell immunotherapy improves the prognosis of patients with high-risk diffuse large B cell lymphoma (DLBCL) after the first complete remission (CR).
Peripheral blood mononuclear cells (PBMCs) were extracted from 20 patients with high-risk DLBCL (IPI≥3) after the first CR. Twenty CR patients who were age- and sex-matched during the same period were selected as controls. PBMCs were cultured with IFN-γ, IL-2 and anti-CD3 mAb to generate CIK cells. These obtained cells were then transfused back into the patients; the transfusion was repeated every 3 months up to a total of four courses. Changes in peripheral blood lymphocyte subgroups and survival were assessed.
Compared with the baseline proportions, the proportion of CD3 T cells, CD3CD8 T cells, and NK cells in the peripheral blood were significantly higher after transfusions (<0.05). The 5-year DFS was improved from 45.0 ± 11.1% to 79.3 ± 9.2% in the CIK group (HR favoring CIK, 0.29; 95% CI, 0.09 to 0.92; = 0.035), and the 5-year OS was estimated at 90 ± 6.7% for CIK versus 55 ± 11.1% for control (HR favoring CIK, 0.20; 95% CI, 0.04 to 0.93; = 0.040). No severe side effects were observed related to CIK treatment.
Autologous CIK cell immunotherapy has emerged as a safe and efficacious option to improve the prognosis of patients with high-risk DLBCL after the first CR.
评估自体细胞因子诱导的杀伤（CIK）细胞免疫疗法是否能改善高危弥漫性大B细胞淋巴瘤（DLBCL）患者首次完全缓解（CR）后的预后。
从20例首次CR后的高危DLBCL（国际预后指数[IPI]≥3）患者中提取外周血单个核细胞（PBMC）。选取同期年龄和性别匹配的20例CR患者作为对照。PBMC与干扰素-γ、白细胞介素-2和抗CD3单克隆抗体共同培养以生成CIK细胞。然后将获得的细胞回输至患者体内；每3个月重复回输一次，共进行四个疗程。评估外周血淋巴细胞亚群的变化和生存率。
与基线比例相比，回输后外周血中CD3⁺T细胞、CD3⁺CD8⁺T细胞和自然杀伤（NK）细胞的比例显著升高（<0.05）。CIK组的5年无病生存率（DFS）从45.0±11.1%提高到79.3±9.2%（支持CIK的风险比[HR]，0.29；95%置信区间[CI]，0.09至0.92；P = 0.035），CIK组的5年总生存率（OS）估计为90±6.7%，而对照组为55±11.1%（支持CIK的HR，0.20；95%CI，0.04至0.93；P = 0.040）。未观察到与CIK治疗相关的严重副作用。
自体CIK细胞免疫疗法已成为改善高危DLBCL患者首次CR后预后的一种安全有效的选择。
