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本研究旨在观察低甲基化药物地西他滨联合自体细胞因子诱导的杀伤细胞(CIK)治疗老年急性髓系白血病(AML)的安全性及有效性。本科于2006-2012年收治2例80岁以上老年AML患者(M4型和M6型),均继发于骨髓增生异常综合征。对这2例患者先后采取单用自体CIK细胞输注、地西他滨或(和)自体CIK细胞方案治疗,系统观察了2例CIK治疗前后淋巴细胞亚群、临床相关指标(血液学反应、输血频率、白血病相关基因表达、缓解情况、生活质量)及生存期的变化。结果表明,与单用自体CIK细胞输注和单用地西他滨治疗相比,地西他滨联合自体CIK细胞治疗方案可减轻骨髓抑制程度,降低输血频率及输血量,延长部分缓解持续时间,同时表达的白血病相关基因减少,生存期显著延长,患者生活质量得到明显改善。结论:地西他滨联合自体CIK细胞治疗老年AML患者安全有效。
This study aimed to investigate the safety and efficacy of hypomethylated drug decitabine combined with autologous cytokine-induced killer cells (CIK) in the treatment of elderly patients with acute myeloid leukemia (AML). In the undergraduate course from 2006 to 2012, 2 cases of AML patients aged 80 years or older (M4 and M6) were admitted to the hospital and were secondary to myelodysplastic syndrome. The two patients were treated with the autologous CIK cell infusion, decitabine or (and) autologous CIK cells, and the lymphocyte subsets and clinically relevant indicators (hematologic response) before and after CIK treatment were systematically observed. Transfusion frequency, leukemia-associated gene expression, remission, quality of life, and survival. The results showed that compared with infusion of autologous CIK cells alone and decitabine alone, decitabine combined with autologous CIK cell therapy can reduce the degree of myelosuppression, reduce blood transfusion frequency and blood transfusion, and prolong partial remission duration. At the same time, the expression of leukemia-related genes was reduced, the survival period was significantly prolonged, and the quality of life of patients was significantly improved. Conclusion: Decitabine combined with autologous CIK cells is safe and effective in the treatment of elderly patients with AML.