自体CIK细胞联合IL-2治疗老年人B细胞性恶性淋巴瘤的临床研究

Clinical Study of Autologous Cytokine Induced Killer Cells Combined with IL-2 for Therapy of Elderly Patients with B-cell Malignant Lymphoma

本研究评价自体CIK细胞联合IL-2治疗老年人B细胞性恶性淋巴瘤的有效性和安全性。采集9例老年B细胞性恶性淋巴瘤患者外周血单个核细胞,在体外经干扰素-γ(IFN-γ)、白介素-2(IL-2)、抗CD3单克隆抗体诱导成CIK细胞,回输细胞数为(2-3)×109个,回输后应用IL-2 100万U/day,皮下注射,第1-10天。28天为1个疗程,共完成了64个周期的自体CIK细胞输注。观察治疗前后细胞免疫功能、肿瘤相关生物学指标、影像学特征、疾病缓解情况、生活质量及生存期的变化。结果表明,7例接受8个周期的CIK细胞输注的患者和2例接受4个周期的输注的患者均未出现不良反应。CIK细胞治疗后CD3+、CD3+CD8+、CD3+CD56+细胞比例明显升高(p<0.05),β2微球蛋白、LDH水平显著下降(p<0.05)。所有患者症状改善、生活质量显著提高(p<0.01)。8例达完全缓解,1例完成8周期的CIK细胞输注后曾一度达良好的部分缓解,但因上呼吸道感染并发急性大面积心肌梗死和淋巴瘤持续进展而死亡。结论:自体CIK细胞联合IL-2治疗老年人B细胞性恶性淋巴瘤安全有效。

Objective of this study was to evaluate the effectiveness and safety of autologous cytokine induced killer（CIK） cells combined with IL-2 in treatment of elderly patients with B-cell malignant lymphoma.Peripheral blood mononuclear cells（PBMNC） were isolated from 9 elderly patients with B-cell malignant lymphoma,and then induced into CIK cells by IFN-γ,IL-2 and monoclonal antibody（mAb） against CD3.The autologous CIK cells [（2-3）×109 ]thus obtained were infused back to individual patients,then followed by subcutaneous injection of IL-2 at single daily dose of 1×104 U/day for 10 consecutive days.The regimen was repeated every 4 weeks and total 64 cycles of CIK cell transfusion were completed.The changes in cellular immune function,tumor-related biological parameters,imaging characteristics,the condition of remission,quality of life and survival time were assessed.7 patients received 8 cycles of CIK cell infusion,and 4 cycles were completed in 2 patients.The results showed that no adverse reaction was observed in all above mentioned patients.The percentages of CD3＋,CD3＋CD8＋ and CD3＋CD56＋ increased significantly（p0.05）,and serum levels of β2-microglobulin and LDH were markedly decreased（p0.05） after autologous CIK cell transfusion.The lymphoma symptoms were relieved with quality of life obviously elevated（p0.01） in all patients.Complete remission was seen in 8 patients.Though one patient received 8 cycles of CIK cell transfusion therapy and achieved transient very good partial remission,but he died of acute large-area myocardial infarction and persistent progression of lymphoma.In conclusion,regimen of autologous CIK cells combined with IL-2 is safe and effective for the therapy of elderly patients with B-cell malignant lymphoma.