树突状细胞与细胞因子诱导的杀伤细胞共培养细胞过继免疫治疗儿童急性白血病

Co-Cultured Dendritic Cell and Cytokine-Induced Killer Cell Adaptive Immunotherapy for Treating of Childhood Acute Leukemia

目的观察树突状细胞(DC)与细胞因子诱导的杀伤细胞(CIK)共培养细胞(DC-CIK)过继免疫治疗儿童急性白血病的作用及安全性。方法回顾分析2005年5月-2011年5月本院确诊经联合化疗后达完全缓解的47例急性白血病患儿临床资料,观察DC-CIK过继免疫治疗过程中细胞采集、细胞培养、细胞回输的安全性,随访过程中通过定期检测其血常规、肝肾功能、心电图等来评估其远期安全性;DC-CIK过继免疫治疗后通过定期进行患儿骨髓细胞学、微小残留病(MRD)检测,初步评判其疗效。结果47例患儿接受DC-CIK治疗后44例患儿持续完全缓解(CCR),CCR率达93.62%;治疗前MRD阳性的9例患儿,8例治疗后转阴。47例患儿共接受DC-CIK过继免疫治疗61例次,不良反应轻微,单个核细胞采集术后局部有轻微疼痛,且均在术后2 h左右自行缓解。细胞培养过程中进行3次病原体检测,仅1例次培养出毛霉菌。细胞回输过程中23例次出现发热,10例次出现皮疹。中位随访41(5～72)个月未见心、肝、肾等重要器官功能损害,未见感染性疾病、第二肿瘤等的发生。结论 DC-CIK过继免疫治疗儿童急性白血病操作流程简便易行、安全性好,获得了满意疗效。

Objective To determine the efficacy and safety of treatment of co - cultured dendritic cell and cytokine - induced killer cell （ DC - CIK） adaptive immunotherapy for treating childhood acute leukemia. Methods The clinical data of the 47 patients with acute leuke- mia were collected from May 2005 to May 2011. All of the patients had achieved complete remission after combined chemotherapy with the proposal of acute leukemia. The clinical data of the patients were analyzed retrospectively and the safety and efficacy of DC - CIK adaptive im- munotherapy system were evaluated. Results Forty - four out of the 47 patients achieved continuous complete remission （CCR） （ 93.62% ） after receiving the DC - CIK adaptive immunotherapy. Minimal residual disease in 9 patients were positive before the treatment, and 8 cases of them were negative after the treatment. Forty - seven patients received a total of 61courses of DC - CIK cells. The main consequences during the collection of mononuclear ceils were mild pain and bruise at the site of aspiration, which were relieved in 2 hours. During the culture of the DC - CIK cells, only 1 patient＇s cells were contaminated by mold fungus. Fever and chill were observed in 23 courses of the infusion of DC - CIK cell, while rushes appeared in 10 times. However, all of them disappeared immediately after treatment. The patients were followed up a- bout 41 months （5 -72 months） and no harmfulness to the critical organs was found, as well as infectious diseases or second neoplasm. Con- clusions DC - CIK cell adaptive immunotherapy is convenient to operate, and safe for children. What＇s more, and it has a very good curative effect among children with acute leukemia. It is worth to do more clinical trials.