【摘要】 目的 探讨恶性血液病自体造血干细胞移植后应用树突状细胞细胞因子诱导的杀伤细胞(DCCIK)预防复发的效果。方法 12例恶性血液病病人自体造血干细胞移植后静脉输注及腹股沟注射DCCIK 细胞2~3次,观察疾病的复发情况以及DCCIK 细胞输注后的副作用。结果 7例持续完全缓解(CR),中位CR期44(32~56)月。4例死亡,其中3例复发。结论 DCCIK细胞治疗可能有助于清除微小残留病,预防疾病复发,延长病人生存期,且副作用小,临床可以选用DCCIK细胞预防自体造血干细胞移植后恶性血液病的复发。
【关键词】 DCCIK细胞;造血干细胞移植;移植,自体;复发
EFFECTS OF DCCIK CELLS ON PREVENTION OF RECURRENCE OF MALIGNANT HEMATOPATHY AFTER HEMATOPOIETIC STEM CELL TRANSPLANTATION
WANG LING, SHI CHUNLEI, LI YING, et al
Department of Hematology, Qingdao Central Hospital, Qingdao 266042, China);
[ABSTRACT] Objective To observe the clinical efficacy of dendritic cells in combination with cytokineinduced killer cells (DCCIK) to prevent recurrence of malignant hematopathy after autohematopoietic stem cell transplantation (AutoHSCT).Methods After autoHSCT, 12 patients with malignant hematopathy were treated with DCCIK cells intravenously and intradermally for 2-3 times a week. The recurrence and side effects DCCIK were followed up. Results Complete remission (CR) was found in seven patients, the median CR period was 44 (range 32-56) months, four died, in which, recurrence was note in three patients. Conclusion Treatment with DCCIK cells may be helpful in clearing minimal residual disease, preventing relapse and prolonging the patients’ life with less side effects, which can be used to prevent recurrence of malignant hematopathy after autoHSCT.
[KEY WORDS] DCCIK cells; hematopoietic stem cell transplantation; transplantation, antologous; recurrence
自体造血干细胞移植是治疗恶性血液病的有效方法之一,自体造血干细胞移植可以将化疗剂量提高到致死量,从而达到减少残留病、降低复发率的作用。但是因为大剂量化疗后仍然存在微小残留病,不能完全解决移植后复发的问题,使得自体造血干细胞移植的应用受到一定限制。国内外采用体内外净化的方法去除移植物中部分残留的肿瘤细胞,但因为造价昂贵、植活时间延长等原因导致净化方法不能广泛应用。我院自2004年8月以来,对12例恶性血液病病人在自体造血干细胞移植后应用自体树突状细胞细胞因子诱导的杀伤细胞(DCCIK)治疗,观察其预防复发的效果以及副作用。现将结果报告如下。
1 资料和方法
1.1 一般资料
12例病人中,男8例,女4例,中位数年龄48(13~56)岁。其中急性白血病4例,分别为急性非淋巴细胞白血病(ALL)2例,急性淋巴细胞白血病2例;非霍奇金淋巴瘤6例;
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