CAJ | 학술논문

目的：分析41例急性白血病微小残留病变的DC-CIK细胞治疗前后实验室检测指标改变特点，探讨其临床治疗意义。方法33例急性髓细胞白血病（ AML）患者均经MA方案（米托蒽醌、阿糖胞苷200 mg）或维甲酸/三氧化二砷诱导缓解，2例M2患者采用CAG方案（阿克拉霉素，阿糖胞苷，粒系集落刺激因子300μg/d）诱导缓解，8例急性淋巴细胞白血病患者均经VDCLP方案（长春新碱，柔红霉素，环磷酰胺，左旋门冬酰胺酶，泼尼松）诱导缓解。所有患者应用大剂量强化化疗方案缓解后用 DC-CIK交替维持治疗。结果 DC-CIK治疗后CD3﹢、CD3﹢CD8﹢、CD3﹢CD56﹢/CD16﹢细胞比例明显提高，差异有统计学意义。治疗后白细胞介素（ IL）-2、IL-12、IL-17、肿瘤坏死因子-α、干扰素-γ水平提高，而IL-8水平降低，差异有统计学意义。治疗前后微小残留灶WT1的检测显示3例AML 患者治疗前WT1阳性，经DC-CIK 治疗后转阴。IL-17健康对照组最高，未缓解及初治白血病最低，缓解组逐渐升高，DC-CIK治疗后接近正常。结论 DC-CIK免疫治疗急性白血病清除微小残留病变能改善患者免疫抑制状态，提高机体的抗急性白血病免疫效应，有较好的临床疗效。
목적：분석41례급성백혈병미소잔류병변적DC-CIK세포치료전후실험실검측지표개변특점，탐토기림상치료의의。방법33례급성수세포백혈병（ AML）환자균경MA방안（미탁은곤、아당포감200 mg）혹유갑산/삼양화이신유도완해，2례M2환자채용CAG방안（아극랍매소，아당포감，립계집락자격인자300μg/d）유도완해，8례급성림파세포백혈병환자균경VDCLP방안（장춘신감，유홍매소，배린선알，좌선문동선알매，발니송）유도완해。소유환자응용대제량강화화료방안완해후용 DC-CIK교체유지치료。결과 DC-CIK치료후CD3﹢、CD3﹢CD8﹢、CD3﹢CD56﹢/CD16﹢세포비례명현제고，차이유통계학의의。치료후백세포개소（ IL）-2、IL-12、IL-17、종류배사인자-α、간우소-γ수평제고，이IL-8수평강저，차이유통계학의의。치료전후미소잔류조WT1적검측현시3례AML 환자치료전WT1양성，경DC-CIK 치료후전음。IL-17건강대조조최고，미완해급초치백혈병최저，완해조축점승고，DC-CIK치료후접근정상。결론 DC-CIK면역치료급성백혈병청제미소잔류병변능개선환자면역억제상태，제고궤체적항급성백혈병면역효응，유교호적림상료효。
Objective To analyze the change characteristics of laboratory test indexes before and after treatment with DC-CIK cells for 41 cases of acute leukemia minimal residual disease,and investigate its clinical significance. Methods Thirty-three cases of AML were treated with MA regimen( 200 mg mitoxantrone,Ara)remission induced by arsenic trioxide or retinoic acid,2 cases of M2 were treated with CAG scheme( Accra mycin,cytarabine,granulocyte colony-stimulating factor 300 μg/d)induction of remission,8 cases were treated with VDCLP regimen( vincristine,doxorubicin,cyclophosphamide, prednisone,L-asparaginase,)induced remission. All patients had remission with large dose of intensive chemotherapy,and then with DC-CIK alternating maintenance treatment. Results After DC-CIK treat-ment,the CD3 ﹢,CD3 ﹢ CD8 ﹢,CD3 ﹢ CD56 ﹢/CD16 ﹢ cell ratio significantly increased,the differences were significant. The levels of IL-2,IL-12,IL-17,TNF-α,IFN-γlevels increased after treatment,and the level of IL-8 decreased,there were significant differences. Detection of minimal residual foci of WT1 showed positive WT1 in 3 cases of AML patients before treatment. After treatment of DC and CIK, showed negative WT1. IL-17 level in healthy control group was the highest,and the lowest in patients with initial treatment and without remission leukemia,in remission group,IL-17 level gradually in-creased,after the treatment with DC-CIK,returned to normal range. Conclusions DC-CIK immune therapy in treatment of acute leukemia minimal residual disease can improve the removal of immunosup-pression in patients with acute leukemia,and improve the immunity,has good clinical curative effect.