摘要
目的:探讨反应停治疗难治复发多发性骨髓瘤(RRMM)的疗效与细胞免疫功能的变化。方法:对26例RRMM患者给予连续6个月以上反应停治疗,在反应停治疗前后检测T细胞亚群、NK细胞及血清IL-2、IFN-7、TNF—α水平的变化。结果:3例患者因不良反应停药,反应停治疗RRMM的总有效率为60.9%(14/23)。患者反应停治疗前CD4^+T细胞(30.89±5.92)%、NK细胞(12.31±3.28)%、CD4/CD8比值(0.76±0.18)以及血清IL-2(88.91±19.57)ng/L、IFN-γ(78.53±28.47)ng/L,均显著低于正常对照组(均P〈0.01),CD8^+T细胞(41.83±7.99)%、TNF—α(127.73±25.09)ng/L,显著高于正常对照组(均P〈0.01)。反应停治疗有效的患者CD4^+T细胞、NK细胞、CD4/CD8比值以及血清IL-2、IFN-γ/水平治疗后逐渐上升,CD8^+T细胞、TNF—α逐渐下降,治疗前后对比均差异有统计学意义(均P〈0.01),反应停治疗无效的患者治疗前后对比均差异无统计学意义(均P〉0.05)。结论:反应停治疗RRMM有效且不良反应小,它可能通过调节体内细胞免疫反应发挥抗瘤作用。
Objective: To investigate the change of cellular immune function of the patients with refractory or relapsed multiple myeloma before and after treatment with thalidomide. Method: The study involved 26 patients with relapsed or refractory multiple myeloma who were qualified to thalidomide treatment. They received thalidomide treatment for consecutive 6 months or more. We measured the CD4^± cell,CD8^± cell, CD56^± cell, CD4/CD8 in peripheral blood and the serum levels of IL-2, IFN-γ, TNF-α at 0, 3, 6 months after treatment with thalidomide. Result:23 cases could be analyzed except 3 patients who withdraw from the study because of severe sideeffects of thalidomide. The total response rate was 60.9% (14/23). Before therapy the CD4^± cell, CD8^± cell, CD56- cell, CD4/CD8 in the peripheral blood and the serum levels of IL-2, IFN-γ, TNF-α were 30.89 ± 5.92%, 41.83±7.99%, 12.31±3.28%, 0.76±0.18, 88.91±19.57 ng/L, 78.53±28.47 ng/L and 127.73±25.09 ng/ L,respectively. The CD4^+ cell, CD56^- cell, CD4/CD8 and the serum levels of IL-2, IFN-γ were significantly lower in patients with relapsed or refractory multiple myeloma than those in normal healthy individuals ( P 〈 0.01), but the CD8 ^+cell and TNF-α were higher than normal healthy individuals ( P 〈0.01). We found the significant increase of CD4^+ cell, CD56^+ cell, CD4/CD8, IL-2, IFN-γ and decrease of CD8^+ cell, TNF-α in patients responding to thalidomide after 3 or 6 months of therapy ( P 〈0.01). But no significant change of cellular immune function was seen in those failing to respond to thalidomide ( P 〈0.05). Conclusion: Thalidomide was active and mild side-effect agents against advanced myeloma. It may induce anti-tumor effects through adjusting cellular immune function.
出处
《临床血液学杂志》
CAS
2007年第4期206-209,共4页
Journal of Clinical Hematology
关键词
反应停
骨髓瘤
多发性
细胞免疫
Thalidomide
Multiple myeloma
Cellular immunity