摘要
目的：研究树突细胞（Dendritic cells,DC）与细胞因子诱导的杀伤细胞（Cytokine-induced killers,CIK）联合化疗治疗高危骨髓增生异常综合征（MDS）患者的临床疗效及安全性。方法：应用DC-CIK联合小剂量HAG治疗23例国际预后积分系统（IPSS）评分为高危（中危Ⅱ及高危组）,经过中位3（2-5）个疗程后评价疗效。结果：完全缓解者（CR）14例,部分缓解者（PR）4例,血液学改善（HI）2例,未缓解者（NR）3例,总有效率86.95%,CR率为60.87%,疗效维持中位时间为6（4.0-8.0）个月,其中11例转为急性白血病,中位转白时间12.5（7.0-18.0）个月,17例死亡,1年生存率为52.5%,2年生存率为26.09%,主要不良反应为骨髓抑制、非感染性发热。中危Ⅱ组和高危组CR率和转白时间无统计学差异（P〉0.05）。23名患者输注DC-CIK 2周后外周CD3^＋、CD4^＋、CD8^＋、CD3^＋CD56^＋淋巴细胞与输注前无明显差异,但1个月时显著高于治疗前（P〈0.05）。结论：DC-CIK免疫治疗与化疗联合应用于老年高危MDS具有良好的协同作用。
Objective： To investigate the efficacy and safety of combination therapy with DC-CIK and low dose chemotherapy for higher risk MDS. Methods： 23 higher risk MDS patients （intermediate 2 or high risk） were enrolled, whose diagnosis was determined according to International Prognostic Scoring System （IPSS）. The outcome was evaluated after median 3 （2 to 5） courses of treatment. Results： Of the 23 cases, 14 cases achieved complete remission（CR）, 4 cases partial remission （PR）, 2 cases hematological improvement （HI）, and 3 cases none remission. The overall response rate was 86.95 %, and CR rate was 60.87 %. The median time of validity was 6 （4.0-8.0）months. 11 cases progressed to acute leukemia, and the median time was 12.5 （7.0-18.0）months. The overall survival rates were 52.5 % at 1 year and 26.09% at 2 years. The major side effect was bone marrow suppression and noninfectious fever. There was no difference in overall response rate and median time of validity between intermediate 2 and high risk group. After treatment with DC-CIK cells, higher percentages of CD3^＋, CD4^＋, CD8^＋, CD3^＋CD56^＋ lymphocytes were detected in all patients at 1 month, but not at 2 weeks. Conclusion： This regiment for high risk MDS is safe and effective.
出处
《现代生物医学进展》
CAS
2015年第3期475-477,502,共4页
Progress in Modern Biomedicine
基金
黑龙江省卫生厅科研课题资助项目(2013093)
