含胸腺肽免疫增强的自体CIK细胞联合IL-2方案治疗高龄弥漫大B细胞淋巴瘤
Treatment of diffuse large B cell lymphoma with combined thymic peptide-enhanced autologous cytokine induced killer cells and IL-2 in aged patients
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摘要: 目的 评价含胸腺肽免疫增强的自体CIK细胞联合IL-2 (TCIL-2) 方案治疗高龄弥漫大B细胞淋巴瘤的有效性和安全性。 方法 采集预先接受胸腺五肽免疫增强治疗的4例高龄弥漫大B细胞淋巴瘤 (DLBCL) 患者外周血单个核细胞, 在体外经干扰素-γ (IFN-γ) 、白介素-2 (IL-2) 、抗CD3单克隆抗体诱导成CIK细胞, 回输细胞数为2×109-3×109个, 回输后应用IL-2 100mU/d, 皮下注射, 连续10d。28d为1个周期, 共完成24个周期的自体CIK细胞输注。观察治疗前后细胞免疫功能、肿瘤相关生物学指标变化。 结果 2例接受8个周期的CIK细胞输注, 2例接受4个周期的输注, 回输后所有患者未出现不良反应。CIK细胞治疗后CD3+、CD3+CD8+、CD3sup>+CD56+细胞比例明显升高 (P＜0.05), β2微球蛋白水平显著下降 (P＜0.05) 。3例达完全缓解, 1例完成8周期的CIK细胞输注后一度达良好的部分缓解, 但最终因急性心肌梗死和淋巴瘤持续进展而死亡。 结论 自体CIK细胞联合IL-2治疗高龄弥漫大B细胞淋巴瘤安全有效。Abstract: Objective To assess the efficiency and safety of combined thymic peptide-enhanced autologous cytokine induced killer（CIK） cells and IL-2 in treatment of diffuse large B cell lymphoma in aged patients. Methods Peripheral blood mononuclear cells（PBMC） were collected from 4 aged patients with diffuse large B cell lymphoma.CIK cells were induced with in vitro interferon gamma（IFN-γ）,IL-2 and anti-CD3 monoclonal antibody（mAb）.Immune function of the cells and tumor-related biological indexes of the patients were observed after 2×109-3×109 autologous CIK cells were re-transfused into the patients each time and IL-2 100mU/d was subcutaneously injected for 10 days,28 days a cycle for 24 cycles. Results Two patients received 8 cycles of CIK cells transfusion and 2 patients received 4 cycles of CIK cells transfusion.No adverse reaction occurred in them.The number of CD3+,CD3+CD8+ and CD33+CD56+ was significantly greater and the serum β2-microglobulin level was markedly lower after CIK cells transfusion than before CIK cells transfusion（P＜0.05）.Complete remission was achieved in 3 patients and 1 patient died of acute large-area myocardial infarction and persistent progression of lymphoma although partial remission was achieved after 8 cycles of CIK cells transfusion. Conclusion Combined autologous CIK cells transfusion and IL-2 is safe and effective for large B cell lymphoma in aged patients.
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