中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (10): 1897-1900.doi: 10.3969/j.issn.1673-8225.2012.10.041

• 干细胞临床实践 clinical practice of stem cells • 上一篇    

自体造血干细胞移植联合异体细胞因子诱导的杀伤细胞及白细胞介素2治疗高危急性髓系白血病2例*★

涂三芳，宋朝阳，李玉华，郭坤元，黄宇贤   

  1. 南方医科大学珠江医院血液科，广东省广州市 510282
  • 收稿日期:2011-10-25 修回日期:2012-01-18 出版日期:2012-03-04 发布日期:2012-03-04
  • 通讯作者: 宋朝阳，主任医师，南方医科大学珠江医院血液科，广东省广州市 510282
  • 作者简介:涂三芳★，女，1983年生，江西省高安市人，汉族，2008年南方医科大学毕业，硕士，主治医师，主要从事造血干细胞移植免疫研究。doctortutu@163.com
  • 基金资助:

    国家自然科学基金项目(30973454)。课题题目：植物多酚联合 allo-NK 细胞清除白血病干细胞的机制研究。

Autologous hematopoietic stem cell transplantation in combination with allogenetic cytokine induced killer cells and interleukin-2 infusion for treatment of high risk acute myelocytic leukemia in two cases 

Tu San-fang, Song Chao-yang, Li Yu-hua, Guo Kun-yuan, Huang Yu-xian   

  1. Department of Hematology, Zhujiang Hospital of Southern Medical University, Guangzhou  510282, Guangdong Province, China
  • Received:2011-10-25 Revised:2012-01-18 Online:2012-03-04 Published:2012-03-04
  • Contact: author: Song Chao-yang, Chief physician, Department of Hematology, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, Guangdong Province, China
  • About author:Tu San-fang★, Master, Attending physician, Department of Hematology, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, Guangdong Province, China doctortutu@163.com
  • Supported by:

    the National Natural Science Foundation of China, No.30973454*

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摘要：

背景：自体造血干细胞移植治疗高危急性髓系白血病的复发率极高，如何降低移植后复发率至今仍是难点。
目的：观察自体造血干细胞移植联合异体细胞因子活化杀伤(CIK)细胞及白细胞介素2治疗高危急性髓系白血病的临床效果。
方法：2例高危急性髓系白血病患者，经诱导化疗及巩固强化治疗后，在第1次缓解期行自体造血干细胞移植, 移植后1个月给予三四疗程异体CIK细胞输注，每隔半年1个疗程，每疗程分5次输注异体CIK细胞，每隔1日输注1次。每次输注CIK细胞前半小时内给予皮下注射白细胞介素2，第1次输注后隔日皮下注射白细胞介素2，半年后减为隔2日1次，1年后减为隔3日1次，1年半后减为1次/周，维持半年后结束，预防白血病复发。
结果与结论：2例患者自体造血干细胞移植后输注异体CIK细胞及皮下注射白细胞介素2无发热、寒战、皮疹等不良反应，无骨髓抑制及移植物抗宿主反应，治疗安全。2例患者持续缓解时间分别为20个月及2年，目前仍无复发。首次得出对于无合适供者的高危急性髓系白血病患者，在缓解后可行自体造血干细胞移植联合异体CIK细胞及白细胞介素2治疗，有机会获得长期无病生存。
 

关键词: 白细胞介素2, 急性髓系白血病, 高危, CIK细胞, 自体造血干细胞移植

Abstract:

BACKGROUND: The relapse rate of patients with high risk acute myelocytic leukemia is very high after treated with autologous hematopoietic stem cells transplantation (AHSCT). How to decrease the relapse rate is still difficult.
OBJECTIVE: To investigate the clinical efficacy of AHSCT combined with allogenentic cytokine-induced killer cells (CIK cells) and interleukin-2 (IL-2) infusion for treatment of high risk acute myelocytic leukemia (AML).
METHODS: Two patients with high risk AML were treated with AHSCT at complete remission first time (CR1) after induction and consolidation chemotherapy. One month after AHSCT, two patients were infused with allogenetic CIK cells for 3-4 courses, with one course for half a year, 5 times per course and once per day. Subcutaneous injection with IL-2 was finished at half an hour before infusing CIK cells every time, the subcutaneous injection of IL-2 was preformed once every 2 days after the first infusion and once every 3 days after half a year, once every 4 days after one year, and once a week after one and half a year. The injection was maintained for half a year to prevent the relapse of AML.
RESULTS AND CONCLUSION: After the two patients were treated with allogenentic CIK cells infusion and subcutaneous injection of IL-2 after AHSCT, there were no side effects appeared such as fever, shivering and erythra, at the same time there were no bone marrow depression and graft versus host disease appeared. The sustained remission time of the two patients was 20 months and 2 years respectively without relapse after AHSCT until now. The first time we find that the patients with high risk AML can acquire disease-free survival longtime with the treatment of AHSCT in combination with immunotherapy of CIK cells and IL-2 when they have no suitable donors.

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