自体CD3AK细胞治疗晚期恶性肿瘤的近期疗效

Anti-CD3 monoclonal antibody activated autologous killer cells in treatment of advanced malignant tumor: an observation of short-term effectiveness

目的:探讨抗CD3单克隆抗体激活的杀伤细胞(anti-CD3 monoclonal antibody activated killer cell,CD3AK)对晚期恶性肿瘤的疗效和患者免疫功能的影响。方法:选取山东大学附属千佛山医院55例实体瘤患者和12例淋巴瘤患者,分离患者外周血单个核细胞,采用抗CD3Ab、IL-2等诱导自体CD3AK细胞,以CD3AK细胞对患者自体回输。并对患者治疗前后的T细胞亚群和NK细胞(CD16+CD56+)水平进行测定。结果:晚期恶性肿瘤患者输注自体CD3AK细胞1个疗程后,实体瘤组治疗有效率为25.45%,临床获益率为74.54%;淋巴瘤组有效率为83.33%,临床获益率为91.67%;治疗后两组患者T细胞亚群中CD8+下降(P<0.05),CD3+、CD4+细胞及CD4+/CD8+比值及NK细胞计数较治疗前显著升高(P<0.05)。结论:自体CD3AK细胞能使晚期恶性肿瘤患者T细胞亚群比例失调和功能低下的状况得到不同程度的改善,有效地控制肿瘤,而且安全性好,无明显不良反应。

Objective：To investigate the therapeutic effects of anti-CD3 monoclonal antibody activated autologous killer cells （CD3AK） in treatment of advanced malignant tumors and their influence on the immune function of patients.Methods： Fifty-five patients with solid tumors and 12 with lymphoma, who were admitted to the Qianfoshan Hospital, Shandong University, were treated with CD3AK cells. IL-2 and CD3 Ab were used to induce autologous CD3AK cells from the peripheral blood mono-nuclear cells （PBMC） from 67 patients. T cells subsets and the level of NK cells（CD16^＋CD56^＋）were determined before and after the treatment. Results： The effective rate of autologous CD3AK cells was 25.45% for the solid tumors and the clinical beneficial rate was 74.54%; the effective rate was 83.33% for lymphoma and the clinical beneficial rate was 91.67%. The CD8^＋ cell subsets was decreased after treatment（P〈0.05）; the CD3^＋,CD4^＋ cell subsets and CD4^＋/CD8^＋ ratio were significantly increased（P〈0.05）after one course of treatment with CD3AK cells. Conclusion： Autologous CD3AK cells can improve the unbalanced T cell subsets in patients with advanced malignant tumors, upgrade the quality of life of patients, and effectively control tumor growth, with better safety and without adverse effect.