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 andconsolidation 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 acqui re di sease-free survival longtime with the treatment of AHSCT in combination with immunotherapy of CIK cells and IL-2 when they have no suitable donors.%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.
展开▼
