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目的评价化疗联合自体细胞因子诱导的杀伤细胞(CIK)治疗急性白血病(AL)的疗效。方法选择经化疗达完全缓解(CR)>6个月的AL患者41例。19例患者接受化疗联合自体CIK细胞治疗,22例接受同期单纯化疗作为对照组。CIK细胞治疗采用血细胞分离机大量采集患者的外周血单个核细胞,用抗CD3单抗、IL2、IFNγ培养10d,将细胞洗涤后经静脉于化疗后第一天回输给患者。结果CIK组19例患者化疗同时共接受52疗程CIK细胞治疗,每例患者平均接受2~3个疗程CIK细胞治疗。每疗程回输CIK细胞总数为(22~300)×109/L,平均(142±85)×109/L。4年持续CR(CCR)率CIK组为734%;单纯化疗组4年预期CCR率为273%。两者差异有统计学意义(P<0005)。接受≥3个疗程CIK治疗的10例患者至观察截止时均处于CCR,中位CCR期43个月(23~52个月);接受<3个疗程CIK治疗的患者4/9例复发。结论化疗联合自体CIK细胞治疗AL的CCR率明显优于单纯化疗;疗效与疗程有关,疗程≥3个患者的疗效优于疗程<3个的患者。
Objective To evaluate the efficacy of chemotherapy combined with autologous cytokine-induced killer cells (CIK) in the treatment of acute leukemia (AL). Methods Forty-one patients with AL were treated by chemotherapy for 6 months after complete remission (CR). Nineteen patients received chemotherapy combined with autologous CIK cells and 22 received concurrent chemotherapy alone as control group. CIK cell therapy A large number of peripheral blood mononuclear cells of patients were collected with a blood cell separator. The cells were cultured with anti-CD3 monoclonal antibody, IL2 and IFNγ for 10 days. The cells were washed and then transfused to the patients via the vein on the first day after chemotherapy. Results In the CIK group, 19 patients received concurrent chemotherapy with 52 cycles of CIK cells. Each patient received 2 to 3 courses of CIK cells on average. The number of CIK cells returned per treatment ranged from (22 to 300) × 109 / L, with an average of (142 ± 85) × 109 / L. The 4-year sustained CR (CCR) rate was 734% in the CIK group, and the 4-year CCR rate in the chemotherapy-alone group was 273%. The difference was statistically significant (P <0005). All 10 patients who received ≥3 cycles of CIK were in CCR by the end of the observation period, with a median CCR of 43 months (range, 23 to 52 months) and 4/9 patients who received <3 cycles of CIK. Conclusions Chemotherapy combined with autologous CIK cells is superior to chemotherapy alone in the treatment of AL. The curative effect is related to the course of treatment. The curative effect of ≥3 patients over 3 patients is better than that of 3 patients.