DC-CIK治疗难治性多发性骨髓瘤的临床研究

Clinical Study of DC-CIK for Refractory Multiple Myeloma

目的探讨树突状细胞(DC)和细胞因子诱导的杀伤细胞(CIK)治疗难治性多发性骨髓瘤的疗效和安全性。方法 41例难治性多发性骨髓瘤患者,根据患者意愿分为22例实验组和19例对照组。将实验组自体DC-CIK细胞进行体外扩增,再过继回输进行治疗。对照组患者接受维持治疗。对过继治疗前后患者的免疫指标以及临床疗效进行对比和观察。结果诱导后CD表面CD1a、CD83、CD86和HLA-DR分子阳性率均较诱导前显著提高,差异有统计学意义(P<0.01)。诱导后DC-CIK表面CD3、CD8和CD56阳性率均较CIK有显著提高,差异有统计学意义(P<0.01)。治疗3个月后,实验组患者QOL、Ag-NOR和外周血IL-12等指标均较对照组有显著优化,差异有统计学意义(P<0.05)。3个月治疗后,实验组患者肾功能、24 h尿液轻链、血清M蛋白、β2-M、骨髓瘤细胞比例均相较对照组有显著改善,差异有统计学意义(P<0.05)。结论 DC-CIK过继治疗难治性MM具有较好的临床疗效,可帮助患者带瘤长期生存,获得较大受益。

Objective To explore the clinical efficacy and security of dendritic cells( DC) and cytokine induced killers( CIK) in the treatment of refractory multiple myeloma( MM). Methods 41 patients with refractory MM were divided into the experimental group and the control group according to their willings,there were 22 cases in the experimental group and 19 cases in the control group. The autologous DC-CIK cells were amplificated in vitro and then for reinfusion treatment. The control group received maintenance therapy. The immune parameters and clinical effects before and after treatment were compared and observed.Results After induction,the positive rates of CD1 a,CD83,CD86 and HLA-DR molecules on CD surface improved significantly,the difference was statistically significant( P < 0. 01). After induction,the positive rates of CD3,CD8 and CD56 molecules on CDCIK surface improved significantly than those of CIK,the difference was statistically significant( P < 0. 01). After 3 months of treatment,The QOL,Ag-NOR and peripheral IL-12 of patients in the experimental group were all significantly optimized compared to the control group,the difference was statistically significant( P < 0. 05). After 3 months of treatment,the renal function,urine light chain,serum M protein,β2-M and the proportion of myeloma cells were significantly improved compared to the control group,the difference was statistically significant( P < 0. 05). Conclusion DC-CIK for refractory MM has good clinical effect,it can improve long-term survival of patients with tumors with large benefit.