CIK细胞与VD方案治疗老年复发/难治性多发性骨髓瘤的临床观察

Clinical observations between cytokine-induced killer cell immunotherapy and bortezomib plus dexamethasone regimen in elderly patients with relapsed/refractory multiple myelom

目的比较细胞因子诱导的杀伤细胞(CIK细胞)与硼替佐米联合地塞米松(VD)方案治疗老年复发/难治性多发性骨髓瘤的临床疗效及不良反应。方法回顾性选择2009年10月–2012年10月收治的30例老年复发/难治性多发性骨髓瘤患者,分为CIK组14例,给予静脉回输CIK细胞免疫治疗;VD组16例。依据欧洲血液和骨髓移植协作组标准考察两种疗法的疗效,并根据美国国家癌症研究所不良事件常用术语研究标准判断不良反应。结果 CIK组14例患者总体缓解率高于VD组(57.1%vs 43.8%,P>0.05),完全缓解和接近完全缓解的比例之和低于VD组(14.2%vs 18.8%,P>0.05)。CIK组与VD组中位疾病无进展生存期分别为8(1~35)个月和7(1~32)个月(P>0.05)。CIK组有效改善了患者体力、食欲和睡眠。其主要不良反应为一过性发热;VD方案主要不良反应为乏力、血小板减少及周围神经病变。结论 CIK细胞治疗老年复发/难治性多发性骨髓瘤安全有效,不良反应小,耐受性好,生活质量提高,较之VD方案更适合用于老年复发/难治性多发性骨髓瘤的治疗。

Objective To compare the clinical outcomes between cytokine-induced killer (CIK) cell immunotherapy and bortezomib plus dexamethasone (VD) regimen in elderly patients with relapsed/refractory multiple myeloma (MM). Methods 30 elderly patients with relapsed/refractory MM were enrolled in this study, among which 14 patients received immunotherapy of autologous CIK cell transfusion (CIK group) and 16 patients received the therapy of VD regimen (VD group). Clinical efficacy was evaluated according to Europe blood and bone marrow transplantation cooperation standard, and side-effects were according to national cancer institute common terminology criteria for adverse events (NCICTCAE). Results The overall response rate of CIK group was higher than VD group (57.1%vs 43.8%, P>0.05), and the complete response rate of CIK group was lower than VD group (14.2%vs 18.8%, P>0.05). The median progression-free survival of CIK group and VD group was 8 (1-35) and 7 (1-32) months, respectively (P>0.05). After CIK cell immunotherapy, the main adverse event was transient fever. The main adverse events of VD regimen were fatigue, thrombocytopenia, and peripheral neuropathy. Conclusion CIK cell immunotherapy has minimal toxicity and good tolerance, and is safe and effective in elderly patients with relapsed/refractory MM.