DC-CIK调节弥漫大B细胞淋巴瘤患者细胞免疫功能的临床研究

Clinical research of DC-CIK on regulating cellular immune in patients with diffuse large B cell lymphoma

目的探讨以树突状细胞和细胞因子诱导的杀伤细胞为效应细胞的过继免疫治疗对弥漫大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)患者细胞免疫功能调节的影响。方法选择南阳市第一人民医院2012年4月-2015年4月期间收治的初诊DLBCL患者23例,经过化疗或化疗联合放疗至少达部分缓解。采用Cobe Spectra血细胞分离机采集患者外周血单个核细胞,制备DC-CIK细胞,每例患者至少输注4个疗程。血液细胞分析仪检测外周血淋巴细胞绝对计数,流式细胞术检测总T、Th、Ts、Treg、NK细胞水平,ELISA方法检测INF-γ、IL-2水平,观察治疗的不良反应发生情况。结果 4个疗程DC-CIK细胞治疗后外周血淋巴细胞绝对计数[absolute lymphocyte count,ALC,(2.17±1.58)×10~9/L]明显高于治疗前水平[(0.83±0.79)×10~9/L],差异有统计学意义(P<0.05);Treg细胞水平[(4.92±2.38)%]明显低于治疗前水平[(6.01±2.07)%],差异有统计学意义(P<0.05);外周血总T、Th、Ts、CD3^+ T、CD3^+CD4^+ T、CD3^+CD8^+ T、NK细胞、IL-2和INF-γ平均水平在治疗前后差异无统计学意义(P>0.05)。结论自体DC-CIK细胞治疗可以通过提高ALC、降低Treg细胞水平改善初治DLBCL患者的细胞免疫功能。

Objective To investigate the effect of autologous dendritic cells and cytokine-induced killer cells transfusion therapy on the improvement of immune function in patients with diffuse large B-cell lymphoma(DLBCL). Methods Total 23 cases of diffuse large B-cell lymphoma confirmed by histological and immunohistochemical were selected from Nanyang First People Hospital during April 2012 to April 2015. All of the patients attained to at least partial remission. Peripheral blood mononuclear cells were isolated by Cobe Spectra blood cell separator, and induced into DC-CIK cells by conventional methods. DC-CIK cells were intravenous injected into patients twice every 15 days, a total of 4 times. The changes of absolute lymphocyte count were detected by hematology analyzer and peripheral lymphocyte subsets were detected by flow cytometry. The levels of INF-γ, IL-2 in serum were detected by Elisa. Meanwhile, the adverse reactions were observed. Results After 4 times DC-CIK cells transfusion therapy, the level of ALC [(2.17±1.58)×10~9/L] were significantly higher than those before treatment level [(0.83±0.79)×10~9/L], P<0.05. The ratio of Treg cell was significant decreased [(4.92±2.38)% vs.(6.01±2.07)%], P<0.05. It was found that numerical value of T, Th, Ts, CD3^+ T, CD3^+CD4^+ T, CD3^+CD8^+ T, NK cell, IL-2 and INF-γ was not statistically difference before and after treatment(P>0.05). Conclusion Autologous DC-CIK cell immunotherapy can improve the DLBCL patients’ cellular immune function by improving ALC and reducing Treg.