免疫治疗联合化疗对多发性骨髓瘤患者外周血T、B淋巴细胞及调节性T细胞水平的影响

Effect of Immunotherapy Combined with Chemotherapy on Peripheral Blood T, B Lymphocyte, and Regulatory T Cell Levels in Patients with Multiple Myeloma

【目的】探讨免疫联合化疗对多发性骨髓瘤（MM）患者外周血T、B淋巴细胞及调节性T细胞（Tregs）水平的影响。【方法】本院收治的MM患者60例，采用数字随机对照表分为两组，每组各30例；对照组给予DC-CIK免疫治疗＋化疗，对照组仅给予化疗，评估两组临床疗效，观察两组T淋巴细胞、Tregs水平、B细胞、浆细胞比例水平变化；随访1年，比较两组复发率。【结果】观察组治疗有效率为53．33％（i6／30）显著高于对照组26．67％（8／30），1年复发率为6．67％（2／30）显著低于对照组30．0％（9／30），且差异有显著性（P〈0．05）。观察组治疗后CD4＋T淋巴细胞比例、CD4＋／CD8＋T淋巴比值显著高于对照组，CD8＋T淋巴细胞比例显著低于对照组，且差异有显著性（P〈0．05）。观察组治疗后CD4＋CD25＋Tregs、CD4＋CD25 high Tregs显著低于对照组，且差异有显著性（P〈0．05）。观察组治疗后B细胞比例高于对照组，浆细胞比例低于对照组，且差异有显著性（P〈0．05）。【结论】DCcIK免疫治疗＋化疗能够改善MM患者免疫功能紊乱症状，降低浆细胞比例，提高临床疗效。

[Objective]To investigate the effects of immunotherapy combined with chemotherapy on peripheral blood T, B lymphocyte, and regulatory T cell （Tregs） levels in patients with multiple myeloma （MM）. [Methods] Sixty patients with MM who were admitted into our hospital were divided into 2 groups by a random number control table, with 30 cases in each group. Patients in the observation group were treated with DC-CIK immunotherapy combined with chemotherapy while the control group were treated only with chemotherapy. The clinical curative effects in the two groups were evaluated. The changes of T, B lymphocytes, Tregs levels, and plasma ceils rates in the two groups were observed; After one year of follow-up, the recurrence rates in the two groups were recorded. [Results] The effective rate in the observation group [53.33% （16/30）] was significantly higher than that in the control group [26.67% （8/30）], and the one year recurrence rate [6.67% （2/30）] was significantly lower than that in the control group [30.0% （9/30）] （ P 〈0.05）. After treatment, CD4＋ T lymphocyte proportion and CD4＋/CD8＋ T lymphocyte ratio in the observation group were significantly higher than those in the control group while CD8＋ T lymphocyte proportion was significantly lower than that in the control group （ P 〈0.05）. After treatment, CD4＋ CD25＋ Tregs and CD4＋ CD25high Tregs levels in the observation group were significantly lower than those in the control group （ P 〈0.05）. After treatment, the proportion of B cells in the observation group was higher than that in the control group while the proportion of plasma cells was lower than that in the control group （ P 〈0.05）. [Conclusion]DC-CIK immunotherapy combined with chemotherapy can relieve the symptoms of immune dysfunction in patients with MM, reduce the proportion of plasma cells and improve the overall clinical curative effect.