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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。

英文摘要:

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.

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