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目的观察树突状细胞(DC)与细胞因子诱导的杀伤细胞(CIK)共培养细胞(DC-CIK)过继免疫治疗儿童急性白血病的作用及安全性。方法回顾分析2005年5月-2011年5月本院确诊经联合化疗后达完全缓解的47例急性白血病患儿临床资料,观察DC-CIK过继免疫治疗过程中细胞采集、细胞培养、细胞回输的安全性,随访过程中通过定期检测其血常规、肝肾功能、心电图等来评估其远期安全性;DC-CIK过继免疫治疗后通过定期进行患儿骨髓细胞学、微小残留病(MRD)检测,初步评判其疗效。结果47例患儿接受DC-CIK治疗后44例患儿持续完全缓解(CCR),CCR率达93.62%;治疗前MRD阳性的9例患儿,8例治疗后转阴。47例患儿共接受DC-CIK过继免疫治疗61例次,不良反应轻微,单个核细胞采集术后局部有轻微疼痛,且均在术后2 h左右自行缓解。细胞培养过程中进行3次病原体检测,仅1例次培养出毛霉菌。细胞回输过程中23例次出现发热,10例次出现皮疹。中位随访41(5～72)个月未见心、肝、肾等重要器官功能损害,未见感染性疾病、第二肿瘤等的发生。结论 DC-CIK过继免疫治疗儿童急性白血病操作流程简便易行、安全性好,获得了满意疗效。
Objective To observe the effect and safety of adoptive immunotherapy of dendritic cells (DC) and cytokine-induced killer (CIK) co-cultured cells (DC-CIK) on acute leukemia in children. Methods The clinical data of 47 children with acute leukemia who were diagnosed as having complete remission after combined chemotherapy in our hospital from May 2005 to May 2011 were retrospectively analyzed. The cell collection, cell culture and cell transfusion in DC-CIK adoptive immunotherapy were observed. The safety of follow-up was evaluated by routine testing of blood routine, liver and kidney function, electrocardiogram, etc. After DC-CIK adoptive immunotherapy, children with myelocytosis, minimal residual disease (MRD) Test, preliminary assessment of its efficacy. Results Forty-four children (47.6%) had complete remission (CCR) after treatment with DC-CIK, with a CCR rate of 93.62%. Nine of the MRD-positive children were treated before treatment, and 8 were negative after treatment. Forty-seven cases received DC-CIK adoptive immunotherapy for 61 times, with mild adverse reactions. Localized mononuclear cells were slightly painful after operation and were relieved at about 2 hours after operation. Pathogen detection was performed 3 times during cell culture, only 1 case of Mucor. 23 cases of fever back to the cell during fever, rash appeared in 10 cases. The median follow-up 41 (5 ~ 72) months no heart, liver, kidney and other important organ dysfunction, no infectious disease, the second tumor and so on. Conclusion DC-CIK adoptive immunotherapy of children with acute leukemia is simple, safe, and obtained satisfactory results.