凌丹康复方配合DC-CIK治疗白血病临床观察

作者	单位
刘清池	河北省石家庄平安医院
吴维海	河北省石家庄平安医院
李刚荣	河北省石家庄平安医院
胡晓东	河北省石家庄平安医院
冯新旺	河北省石家庄平安医院
梁春耕	河北省石家庄平安医院
武大勇	河北省石家庄平安医院
张玉娜	河北省石家庄平安医院
庞宇慧	河北省石家庄平安医院
王荣孝	河北省石家庄平安医院
李建英	河北省石家庄平安医院
马传宝	河北省石家庄平安医院
张慧敏	河北省石家庄平安医院
牛景月	河北省石家庄平安医院

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中文摘要:

目的观察中药凌丹康复方配合树突状细胞联合细胞因子诱导的杀伤细胞(DC-CIK)治疗白血病的临床效果和安全性。方法选择血液学缓解但未达到分子生物学缓解的白血病患者或残留白血病检测阳性患者20例,其中缓解期急性白血病19例,慢性粒细胞白血病1例。用血细胞分离机采集患者的外周血单个核细胞,分别培养DC和CIK,然后再混合培养获得DC-CIK。将DC-CIK经静脉回输给患者,每15～20天回输1次,共输注4～6次。同时服用扶正祛邪中药凌丹康复方。结果凌丹康复方配合DC-CIK治疗20例缓解期白血病患者,达分子生物学缓解,标志基因转阴4例,其中1例为AML1/ETO,1例CBFβ/MYH11,1例IgH基因重排,1例bcr/abl;微小残留白血病转为阴性者3例。治疗后3年完全缓解(CR)为75%,中位CR期25个月(10～37个月)。DC-CIK输注后除5例出现一过性发热,畏寒,无其他严重不良反应。结论中药凌丹康复方配合DC-CIK细胞治疗血液学缓解后白血病,具有明显清除微小残留白血病细胞的作用,是血液学缓解后白血病患者合适的选择,静脉输注安全,有较好的临床应用前景。

英文摘要:

Objective To evaluate the effect and safety of Chinese herbal medicine Lingdankang Composite(LDK) combined dendritic cell-cytokine induced killer cells(DC-CIK) in treating leukemia.Methods Subjects were selected from leukemia patients who achieved hematological complete remission(HCR) but not achieved molecular biological remission(MBR),or with minimal residual leukemia(MRL) positive.Twenty patients,19 of acute leukemia and 1 of chronic myelocytic leukemia,were enrolled.DC and CIK from patient’s peripheral blood monocyte were separated respectively by blood cell separator,then DC-CIK was obtained through respective culture followed with mixed cultivation of them,and was infused back to the patient self via intravenous injection.The back infusion of DC-CIK was performed once every 15-20 days for 4-6 times in total.Meantime,LDK was administered orally every day.Results In the 20 patients treated,4 case of HCR achieved MBR,the negatively reversed marker gene was AML1/ETO in 1 case,CBFβ/MYH11 in 1,bcr/abl in 1,and the other 1 was IgH gene rearrangement;3 patients with positive MRL were reversed to negative.The 3-year CR rate was 75% with a medium CR period of 25 months(10-37 months).Except transient fever and chill in 5 cases,no other remarkable adverse reaction happened during or after DC-CIK infusion.Conclusion The combined treatment of LDK and autologous DC-CIK in treating patients with HCR shows an obvious effect of clearing MRL,it is the appropriate choice for curing leukemia of HCR,and is safety for intravenous infusion,so it has potential clinical prospect.

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