DC-CIK联合化疗治疗初发多发性骨髓瘤的疗效及对其Treg细胞功能的影响

Clinical Efficacy of Dendritic Cells and Cytokine-induced Killer Cells Combined with Chemotherapy for Treating Newly diagnosed Multiple Myeloma and their Effect on Function of CD4^+ CD25^+ T Cells in Peripheral Blood

目的:探讨树突状细胞(DC)和细胞因子诱导的杀伤细胞(CIK)为效应细胞的过继免疫联合化疗治疗初发多发性骨髓瘤(MM)的临床疗效及对患者外周血CD4^+CD25^+调节性T(Treg)细胞影响。方法:42例MM患者随机分为两组:化疗组20例,给予合适的化疗方案;联合组22例,除接受合适的化疗外,还给予DC/CIK免疫治疗,比较两组患者的临床疗效及CD4^+CD25^+调节性T(Treg)细胞比例的差异。结果:治疗3个周期后,联合组患者的生活质量和临床疗效:YS评分2.09,瘤细胞15.56%,β2微球蛋白11.36 mg/L,血清M蛋白26.58 g/L;24 h尿液轻链9.86 mg和肌酐120.33μmol/L,而化疗组上述指标检测分别为:2.66.28.22%、17.52 mg/L,36.26 g/L、14.76mg和200.19μmol/L(P值均<0.05)。联合组CD4^+CD25^+/CD4^+细胞数为3.54%,CD4^+CD25^+FoxP3^+/CD4^+CD25^+比值为15.20%,均明显低于化疗组4.68%和27.55%(P<0.05)。结论:DC/CIK免疫治疗可使CD4^+CD25^+Treg细胞活化增强,配合化疗可进一步清除残存的肿瘤细胞,两者具有协同作用。

Objective:To investigate the efficacy of dendritic cells and cytokine-induced killer cells(DC-CIK)combined with chemotherapy for treating newly diagnosed patients with multiple myeloma(MM) and their effect on cellular immune functions of CD4^+ CD25^+ Treg cells in peripheral blood after adoptive immunotherapy.Methods:Fouty two patients with MM were randomly divided into two groups:chemotherapy group and combined therapy group;20patients in chemotherapy group were treated by chemotherapy only,22 patients in combined therapy group were treated by adoptive immunotherapy(DC-CIK) combined with chemotherapy,and the clinical outcomes of patients and the levels of CD4^+ CD25^+ Treg cells in peripheral blood between 2 groups were compared.Results:After treating for 3weeks,the quality of life,clinical index and survival of patients in combined therapy group were better than those of patients in chemotherapy group(P < 0.05);the ratios of CD4^+ CD25^+ /CD4^+ and CD4^+ CD25^+ FoxP3^+ /CD4^+ CD25^+of patients in combined therapy group were obviously lower than those of patients in chemotherapy group(P < 0.05).Conclusion:The immunotherapy of DC-CIK can strengthen the activities of CD4^+ CD25^+ Treg cells,which combined with chemotherapy can be an effective and promising effects for treatment of patients with MM.