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目的观察细胞因子诱导的杀伤细胞(cytokine-induced killer cells,CIK细胞)联合化疗治疗中晚期视网膜母细胞瘤的安全性和近期疗效。方法选取30例D期后视网膜母细胞瘤患儿为研究对象,15例行化疗(对照组),15例行CIK细胞输注联合化疗(联合组)。在化疗前取联合组患儿自体外周血10～35 ml,体外扩增培养约10 d,隔天1次,分3次回输。观察患儿细胞回输过程中的生命体征,监测细胞回输前及回输后4周左右外周血血常规、生化指标、细胞免疫指标变化及生活质量改善情况、不良反应。结果 (1)安全性良好,联合组患儿共接受46个周期的CIK细胞治疗,所有患儿在CIK细胞回输过程中及回输后生命体征稳定。在46个疗程138次的CIK细胞回输过程中,仅有3例次出现发热,24 h后均恢复正常;所有患者未出现过敏反应;肝肾功能、心肌酶结果在细胞回输后未出现显著性变化。(2)在随访期间联合组患儿有效率及疾病控制率(73.3%,93.3%)均较对照组(67.7%,80%)提高,但差异无统计意义。联合组患儿均出现体力增加,食欲改善(P<0.05),联合组细胞免疫指标改善,CD4+CD25+比例变化有统计学意义(P<0.05)。结论在视网膜母细胞瘤患者中进行自体CIK细胞治疗明显改善了患者的近期临床症状,是一种安全的方法。
Objective To observe the safety and short-term efficacy of cytokine-induced killer cells (CIK) combined with chemotherapy in the treatment of advanced retinoblastoma. Methods Thirty children with retinoblastoma after D stage were enrolled in this study. Fifteen patients received chemotherapy (control group) and 15 received CIK cell infusion combined with chemotherapy (combination group). Before chemotherapy, the patients in the combined group received 10 ~ 35 ml autologous peripheral blood and cultured for about 10 days in vitro. Observe the vital signs of the cells during the process of transfusion, monitor the blood routine, biochemical indexes, the changes of cellular immunity index, quality of life improvement and adverse reactions before and 4 weeks after the cells were transfused. Results (1) The safety was good. The children in the combination group received 46 cycles of CIK cell therapy. All the patients had stable vital signs during the CIK cell transfusion and after the transfusion. In 46 courses of 138 CIK cells in the process of transfusion, only 3 cases of fever occurred 24 hours later returned to normal; no allergic reactions in all patients; liver and kidney function, myocardial enzyme results did not appear after cell reinfusion Significant changes. (2) The effective rate and disease control rate (73.3%, 93.3%) in the combined group were significantly higher than those in the control group (67.7%, 80%) during the follow-up period, but the difference was not statistically significant. In the combined group, physical appetite and appetite were improved (P <0.05). The immune indexes of the combination group were improved and the proportion of CD4 + CD25 + was significantly increased (P <0.05). Conclusions Autologous CIK cell therapy in patients with retinoblastoma significantly improves the patient’s recent clinical symptoms and is a safe method.