抗原负载DC-CIK细胞治疗晚期视网膜母细胞瘤的疗效及其安全性

Efficacy and safety of co-cultured autologous tumor antigen-loaded dendritic cells and cytokine-induced killer cells combined with routine therapy in the treatment of advanced retinoblastoma

目的观察抗原负载的树突状细胞(dendritic cell,DC)与细胞因子诱导的杀伤细胞(cytokine induced killer,CIK)共培养(Ag-DC-CIK)细胞对晚期视网膜母细胞瘤(retinoblastoma,RB)的疗效及其安全性。方法收集武警总医院2011-01至2014-01确诊为晚期RB的26例患儿资料,其中13例采用Ag-DC-CIK细胞回输联合常规治疗方案治疗(联合组);其余13例仅采用常规治疗方案治疗(常规组)。对比分析两组患儿资料,观察Ag-DC-CIK细胞治疗的疗效及安全性。结果联合组患儿共接受67疗程134次Ag-DC-CIK细胞治疗。联合组2例D期患儿均获保眼机会,初诊时无手术机会的4例眼外期、远处转移期患儿2例获手术机会;常规组2例D期患儿均未获保眼机会,初诊时无手术机会的4例眼外期、远处转移期患儿仅1例获手术机会。联合组治疗后外周血中CD3+、CD4+、CD4+/CD8+、CD3+CD56+T淋巴细胞比例较治疗前明显升高(均P<0.05),CD8+T淋巴细胞比例较治疗前明显降低(P<0.05);常规组治疗前后外周血中上述细胞比例均无明显变化。在细胞回输过程中,仅1例次出现发热,体温37.8℃,未经处理恢复正常。所有患儿的血生化、肝肾功能及心电图在细胞治疗后与常规组比较,均差异无统计学意义。结论 Ag-DC-CIK细胞治疗晚期RB安全、有效。

Objective To evaluate the clinical efficacy and safety of co-cultured autologous tumor antigen-loaded dendritic cells（ DC） and cytokine-induced killer cells（ CIK）（ Ag-DC-CIK） combined with routine therapy in the treatment of advanced retinoblastoma（ RB）. Methods 26 patients suffering from RB who were diagnosed as advanced RB in the General Hospital of the Chinese People＇s Armed Police Forces between December 2011 and December 2014. 13 patients received Ag-DC-CIK combined with routine treatment（ combination group）. The other patients received routine therapy（ routine group）. Results The combination group totally received 67 cycles（ 134 times） Ag-DC-CIK therapy. At the end of the follow-up,all patients in combination group who suffered D got the opportunity of reserving eyes; 2 out of 4 patients who lost the opportunity of operation had surgery eventually. All the group D patients of routine group underwent enucleation. 1 out of 4 patients who lost the opportunity of operation had surgery eventually. CD3＋,CD4＋,CD4＋/ CD8＋and CD3＋CD56＋proportion in the combination group was higher than in another group,CD8＋proportion in the combination group was lower than in the routine group,and the difference was statistically significant（ P〈0. 05）. Only one patient had a fever（ 37. 8 ℃） during the therapy,and could return to normal itself. Both groups of patients＇ hepatorenal function,blood biochemistry and ECG had no statistically significant differences. Conclusions Ag-DC-CIK combined with routine therapy in the treatment of advanced RB is efficient and safe.