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目的:观察树突状细胞(dendritic cells,DC)联合细胞因子诱导的杀伤(cytokine-induced killer,CIK)细胞治疗复发性多发性骨髓瘤(multiple myeloma,MM)的疗效以及安全性。方法:采集2005年3月至2014年10月江苏省中医院血液科收治的22例复发性MM患者的骨髓瘤细胞以及外周血单个核细胞,体外培养扩增自体DC-CIK细胞,然后回输治疗,对比治疗前后患者免疫指标及临床治疗效果。结果:DC联合CIK细胞治疗复发性MM总体疗效为,完全缓解(CR)2例,接近完全缓解(n CR)5例,部分缓解(PR)7例,轻微治疗反应(MR)3例,疾病进展(PD)5例,总体反应率(CR+n CR+PR)为63.64%(14/22)。DC-CIK细胞治疗后患者外周血T细胞亚群比例较治疗前无明显变化,差异无统计学意义(P>0.05);NK细胞百分率较治疗前明显上升[(22.26±9.67)%vs(12.61±8.78)%],差异有统计学意义(P<0.01);LDH含量[(166±41)%vs(112±21)%]和β2-MG含量[(5.11±2.33)%vs(2.65±1.61)%]较治疗前均有明显下降,差异有统计学意义(P<0.01)。结论:DC-CIK细胞联合治疗复发性MM具有较好的临床疗效,是一种安全、有效的治疗方法,有望进一步在骨髓瘤及其他B细胞肿瘤的临床治疗中得到应用。
Objective: To observe the efficacy and safety of dendritic cells (DCs) combined with cytokine-induced killer (CIK) cells in the treatment of multiple myeloma (MM). Methods: Twenty-two patients with recurrent MM were treated with myeloma cells and peripheral blood mononuclear cells from Department of Hematology, Jiangsu Provincial Hospital of Traditional Chinese Medicine from March 2005 to October 2014. The DC-CIK cells were cultured and expanded in vitro and then transfused Treatment, before and after treatment of patients with immune indicators and clinical treatment. Results: The overall efficacy of DC combined with CIK cells in the treatment of recurrent MM was complete remission (CR) in 2 cases, complete remission (n CR) in 5 cases, partial remission (PR) in 7 cases, mild treatment response in 3 cases, Progress (PD) in 5 cases, the overall response rate (CR + n CR + PR) was 63.64% (14/22). The percentage of T lymphocyte subsets in peripheral blood of patients with DC-CIK after treatment did not change significantly (P> 0.05), and the percentage of NK cells was significantly higher than that before treatment [(22.26 ± 9.67)% vs (12.61 ± 8.78)%], the difference was statistically significant (P <0.01); the content of LDH [(166 ± 41)% vs (112 ± 21)%] and β2-MG content [(5.11 ± 2.33)% vs 1.61)%] than before treatment were significantly decreased, the difference was statistically significant (P <0.01). Conclusion: The combination of DC-CIK cells in the treatment of recurrent MM has good clinical curative effect. It is a safe and effective treatment and is expected to be further applied in the clinical treatment of myeloma and other B-cell tumors.