化疗联合DC-CIK治疗多发性骨髓瘤的疗效及其对VEGF、IL-2及TNF-a的影响

The impact of efficacy and the levels of VEGF,IL-2 and TNF-a of chemotherapy combined immune therapy(DC-CIK) treatment of multiple myeloma

目的 :探讨负载自体抗原致敏的生物免疫疗法(DC-CIK)治疗多发性骨髓瘤(MM)的疗效及其对血管内皮生长因子(VEGF)、白细胞介素-2(IL-2)及肿瘤坏死因子-α(TNF-α)的影响。方法 :2012年1月~2012年12月选取本院收治的120例MM患者为研究对象,根据随机数字表将患者分为对照组及观察组各60例,对照组行常规性化疗治疗,观察组在对照组基础上应用负载自体抗原致敏的DC-CIK联合治疗。结果 :观察组近期总有效率为88.33%高于对照组66.67%。观察组治疗后VEGF及TNF-α水平显著低于对照组,而IL-2水平高于对照组。对两组患者随访2年,观察组总体生存时间为(42.9±3.2)个月显著长于对照组(32.5±2.8)个月,观察组治疗后卡氏(KPS)评分及生存质量(QOL-BREF)评分显著高于对照组。结论 :化疗联合负载自体抗原致敏的DC-CIK可有效提高MM患者治疗效果,延长患者生存时间,提高患者生存质量,其作用机制可能与DC-CIK能有效抑制VEGF、IL-2及TNF-a过表达有关。

Objective To investigate the impact of efficacy and the levels of growth factor(VEGF),interleukin-2(IL-2) and tumor necrosis factor-a(TNF-a) of chemotherapy combined DC-CIK treatment of multiple myeloma.Methods 68 cases of MM patients were divided into control group(n=34) and the observation group(n=34).The control group were underwented with conventional chemotherapy treatment,observation group were underwented with DC-CIK combination therapy with autologous antigen sensitization.Results The total effective rate of observation group 88.23% were higher than control group 61.76%.The levels of VEGF and TNF-a of observation group were after treatment were lower than the control group,whereas the levels of IL-2 were higher than control group.Two groups of patients were followed up for 2 years,overall survival of observed group(42.9± 3.2) was longer than the control group(32.5 ± 2.8) months.The therapy Karnofsky(KPS) score and quality of life(QOL-BREF) of observation group after threatment were higher than control group.Conclusion Chemotherapy with autologous antigen-sensitized load DC-CIK can effectively improve the treatment of MM patients and prolong survival time and improve the quality of life of patients,and its mechanism may be related to DC-CIK can effectively inhibit VEGF,IL-2 and TNF-a overexpression.