重组人白细胞介素-2联合化疗治疗多发性骨髓瘤

Recombinant interlukin-2 plus chemotherapy in treatment of multiple myeloma

目的 研究重组人白细胞介素-2（rIL-2）联合化疗治疗多发性骨髓瘤（MM）的临床疗效及患者免疫功能变化。方法 分单纯化疗组和化疗＋rIL-2组。化疗＋rIL-2组于常规化疗（MP或VAD方案为主的方案）同时联合应用rIL-2，用法为100万U，皮下注射，5次／周，连用4周为1个周期，连续应用4个周期后检测免疫指标（T细胞亚群、NK细胞、CD＋3 CD＋69细胞百分率）变化，采用Bladé标准评价疗效，按照NCI CTCAE（第3版）判断不良反应。结果 化疗＋rIL-2组治疗后CD3、CD4和CD56（NK）阳性百分率及CD4／CD8比值均明显高于化疗前和单纯化疗组化疗后水平，总有效率（CR＋nCR＋PR）、缓解率（CR＋nCR）分别为66.7 %和25.0 %，而单纯化疗组为50.0 %和8.3 %。rIL-2不良反应轻微。结论 rIL-2能够改善MM化疗患者的免疫功能，提高有效率，降低感染率，值得继续应用。

Objective To study the effect of recombinant interlukin-2 plus chemotherapy in treatment of multiple myeloma. Methods We divided into two groups： chemotherapy plus rIL-2 group and simple chemotherapy group. The patients were given at dose of rIL-2 1×10^6 IU/d, ill, qd, for 4 weeks and 4 cycles. After 4 cycles the changes of T-cell subsets of their peripheral blood were determined. Response was evaluated according to Blad criteria. Adverse events were graded according to the National Cancer Institute Common Toxicity Criteria,version 3.0. Results The positive percentages of CD3, CD4, NK, CD69 and CD4/CD8 ratio after chemotherapy in chemotherapy plus rIL-2 group were significantly higher than those before chemotherapy in the same group and those after chemotherapy in the other group. The overall response rate and complete response rate were 66.7 % and 25.0 % vs 50.0 % and 8.3 % respectively. The side effects of rIL-2 were predictable and manageable. Conclusion Recombinant interlukin-2 plus chemotherapy could increase immune function of patients with multiple myeloma and has a higher response rate as compared with simple chemotherapy.