【摘要】 目的:探讨自体DC-CIK细胞联合其它免疫细胞用于治疗血液系统肿瘤患者的安全性、临床疗效及预后。方法:回顾性研究西安交通大学第一附属医院自2014年9月至2016年4月期间接受细胞免疫治疗的血液系统肿瘤患者50例临床资料(共计完成细胞治疗115例次)。根据选择的治疗方案将患者分为双细胞治疗组(DC-CIK治疗)和多细胞治疗组(DC-CIK联合其它免疫细胞);根据治疗疗程分为单疗程组(完成次数<3次)和多疗程组(完成次数≥3次)。分析比较患者治疗前后T淋巴细胞亚群、血常规指标、KPS评分变化及总生存期。结果:按2种方法分组,2组患者治疗前的一般情况包括入组数量、性别、年龄、各T淋巴细胞亚群、血常规指标、KPS评分等方面的比较,差异无统计学意义,说明2组具有可比性。按治疗方案分组,双细胞组治疗后CD4~+/CD8~+比值较治疗前降低,血常规指标中Hb、Plt水平较治疗前降低,治疗前后相比,差异均具有统计学意义(P <0. 05)。多细胞组患者治疗后CD3~+CD4~+比例较治疗前降低,差异具有统计学意义(P <0. 05)。双细胞组患者3年生存率61. 3%,总生存期32. 4个月,多细胞组3年生存率69. 8%,总生存期39. 6个月,2组对比差异无统计学意义(P> 0. 05)。按治疗疗程分组,单疗程组患者治疗后CD3~+比例较治疗前升高,血Hb水平较治疗前下降,差异均具有统计学意义(P <0. 05);多疗程组患者治疗后CD3~+CD4~+比例较前下降,血Plt较前下降,KPS评分较治疗前升高,差异均具有统计学意义(P <0. 05)。2组患者活存情况对比显示,单疗程组3年生存率52%,总生存期28. 7个月;多疗程组3年生存率76. 4%,总生存期40. 9个月,两组对比差异具有统计学意义(P <0. 05)。结论:自体DC-CIK细胞联合其它免疫细胞治疗血液系统肿瘤可改变患者的免疫功能,提高杀伤肿瘤的作用,且多疗程的细胞治疗可提高患者的生活质量,延长生存期,值得临床推广。更多还原

【Abstract】 Objective: To investigate the safety and clinical efficacy of autologous DC-CIK cells combined with other immune cells for patients with hematological malignancies and analyze patient prognosis. Methods : 50 patients with hematological malignancies who received cellular immunotherapy from September 2014 to April 2016 were retrospectively studied in the First Affiliated Hospital of Xi’an Jiaotong University,115 cases times of cellular immunotherapy were performed. According to the selected treatment, the patients were divided into the dual cell group( DC-CIK cell treatment) and the multi-cell group(DC-CIK cell combined with other immune cells); According to the treatment course, the patients were divided into the single course group(completed by < 3 times) and the multiple course group. The changes of T lymphocyte subsets, blood routine indicators and KPS scores as well as the overall survival time before and after treatment were compared and analyzed. Results: The difference of general conditions before treatment including the number of patients, sex,age,T lymphocyte subsets,blood routine indicators, KPS scores and so on in 2 groups divided according to 2 kinds of treatment methods were not statistically significant, indicating that the 2 groups were comparable. Grouped by selected treatment, the CD4~+/CD8~+ ratio, Hb and Plt levels decreased in the dual cell group,compared with those before treatment(P<0.05). The CD3~+ CD4~+ ratio after treatment in multiple cell group decreased,compared with that before treatment(P<0.05). The 3-year survival rate of patients in dual cell and multiple cell groups was 61.3% vs 69. 8%, the overall survival time of patients in 2 groups was 32. 4 months vs 39. 6 months, there were no statisticall differences between 2 groups(P >0. 05). Grouped by treatment course,the CD3~+ ratio after treatment increased,while the Hb level after treatment decreased in single course group, compared with level before treatment(P <0.05). The CD3~+ CD4~+ ratio, Plt level decreased, while the KPS scores increased after treatment in multiple course group,compared with those before treatment(P <0.05). The 3-year survival rate in single course and multiple course groups was52% vs 76. 4%, the overall survival time was 28. 7 months vs 40. 9 months respectively, statistically significant with difference(P < 0. 05). Conclusion: Autologous DC-CIK cells combined with other immune cells in the treatment of hematological malignancies can change the immune function of the patients and improve the antitumor activity. The multicourse treatment can improve the quality of life, prolong the overall survival time, thus worthing clinical promotion.更多还原