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骨髓移植后的免疫治疗

Immunotherapy after bone marrow transplantation

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【作者】 江浩陆道培郭乃榄卢锡京童春荣耿彦彪

【Author】 JIANG Hao, LU Dao Pei, GUO Nai Lan, LU Xi Jing, TONG Chun Rong, GENG Yan Biao (Institute of Hematology, People’s Hospital, Beijing Medical University, Beijing 100044)

【机构】 北京医科大学人民医院血液病研究所!北京100044北京医科大学人民医院血液病研究所!北

【摘要】 目的:研究免疫治疗用于治疗及预防骨髓移植(bone marrow transplantation ,BMT) 后的白血病复发。方法:A组为异基因骨髓移植(AlloBMT) 后白血病复发患者10 例,接受供者白细胞治疗。B组为自身外周血干细胞移植(autogenousperipheralblood stem cellstransplantation,APBSCT)或BMT后共10 例患者输注免疫杀伤细胞(cytokineinduced killer,CIK)细胞治疗。结果:A 组患者中血液学复发的6 例,1 例Ph1 染色体100% 转阴,无病存活至今已超过18 个月,4 例达暂时缓解;1 例未缓解;微小残留及中枢神经系统复发共4 例,均完全缓解,其中Ph1 染色体全部转阴。B组10 例中1 例患者带有的白血病融合基因转阴。结论:(1) 供者白细胞的输注能使某些BMT后慢性粒细胞性白血病遗传学及血液学复发患者完全缓解。(2)CIK 细胞输注是安全的,对某些白血病复发患者的治疗是有效的。

【Abstract】 Objective: To study immunotherapy for leukemia relapse and prophylaxis after bone marrow transplantation(BMT). Methods: In group A, 10 cases of leukemia relapse after Allo BMT were treated with concentrated mononuclear cells from the marrow donor. In group B, 10 cases of leukemia after APBSCT (autogenous peripheral blood stem cells transplantation) or BMT were treated with CIK (cytokine induced killer) cells. Results: Among 6 patients with hematological relapse in group A, one patient has being living well for 18 months with disappearance of the Ph 1 chromosome. 4 patients showed temporary remission and then relapsed again. One patient showed no response. The other 4 patients (2 with CNS relapse and 2 patients with relapse of minimal residual disease) showed remission, and remained Ph 1 chromosome negative. In group B, a patient treated with CIK cells with a special leukemia infused gene (AML/ETO) turned negative after one treatment of CIK cells. Conclusion: (1) Donor derived leukocyte infusion can induce CML post BMT to cytogenetic and hematological CR. It has also therapeutic effects on acute leukemia relapse but is less sustained. (2) CIK cells can be safely infused into patients and is effective in the therapy of leukemia relapse at least in some patients.

  • 【文献出处】 北京医科大学学报 ,JOURNAL OF BEIJING MEDICAL UNIVERSITY , 编辑部邮箱 ,1999年05期
  • 【被引频次】9
  • 【下载频次】136
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