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目的采用体外培养的树突状细胞(DC)致敏、细胞因子诱导激活的杀伤细胞(CIK)治疗自体外周血造血干细胞移植后的急性髓性白血病患者,探讨该方法降低自体造血干细胞移植后复发的作用及其临床应用的安全性。方法将体外培养、扩增的DC-CIK细胞分两次回输给患者。随后给予白细胞介素-2皮下注射,100万U/天,连续10天。观察用药期间的不良反应,治疗结束后定期复查患者血液学及遗传学缓解情况。结果①安全性:4例患者9例次治疗均能顺利进行。DC-CIK细胞回输过程中有3例次出现寒战、发热,经对症处理能迅速缓解。治疗过程中未见其它不适反应,心电图、肝肾功能无明显变化;②疗效观察:1例患者在治疗前存在染色体异常(46,xy,inv(16)),一个疗程后染色体检查正常。4例患者治疗结束后均处于持续血液学及遗传学缓解状态。随访至今,4例患者已分别无病生存2年半、2年、2年、1年。结论DC-CIK细胞治疗急性髓性白血病的安全性较好,不良反应轻微,短期具有一定疗效。是否能有效降低自体外周血造血干细胞移植后急性髓性白血病的复发尚待更多病例的积累,值得开展临床随机对照研究。
OBJECTIVE: To study the effect of dendritic cells (DCs) sensitized in vitro and cytokine-induced activated killer cells (CIK) on patients with acute myeloid leukemia after autologous peripheral blood hematopoietic stem cell transplantation The role of its clinical application of safety. Methods DC-CIK cells cultured and expanded in vitro were transfused to patients twice. Subcutaneous injection of interleukin-2 was then given at 1 million U / day for 10 consecutive days. Adverse reactions observed during the treatment, regular review of patients after treatment hematology and genetic remission. Results ① Safety: 9 cases of 4 cases were successfully treated. DC-CIK cell back to the process of 3 cases appeared chills, fever, the symptomatic treatment can quickly ease. There was no other uncomfortable reaction during the course of treatment, and there was no significant change of electrocardiogram and liver and kidney function. (2) Efficacy Observation: One patient had chromosomal abnormalities before treatment (46, xy, inv (16)) and the chromosome was normal after one course of treatment. Four patients were in continuous hematological and genetic remission after treatment. Up to now, 4 patients have been disease-free survival of 2 years and a half, 2 years, 2 years, 1 year. Conclusions The safety of DC-CIK cells in the treatment of acute myeloid leukemia is good, mild side effects and short-term efficacy. Whether it can effectively reduce the recurrence of acute myeloid leukemia after autologous peripheral blood stem cell transplantation remains to be more cases of accumulation, it is worth carrying out clinical randomized controlled studies.