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。
Abstract
Objective To study the efficacy and safety of cytokine-induced killer cells(CIK cells) combined with chemotherapy in treating advanced retinoblastoma(RB). Methods Thirty child patients with RB at stage D were enrolled for the study. 15 patients received chemotherapy (control group) while the rest were treated with CIK cells infusion combined with chemotherapy (study group), from whom 10-35 ml autologous peripheral blood was taken before chemotherapy to culture CIK cells in vitro for about 10 days. CIK cells were reinfused every other day three times. The vital signs in the process of cell reinfusion were observed. Changes of peripheral blood indexes, biochemical indexes, immunity indexes, life quality and side effects were also monitored four weeks after the reinfusion. Results (1) CIK cells reinfusion was safe. 15 patients received a total of 46 cycles of CIK cells therapy. Vital signs of all the children were stable. During the 46 courses (138 times) of CIK cells reinfusion, only three cases of patients had a fever during the first 24 hours. No patients had any allergic reactions. With regard to liver and kidney functions and cardiac enzymes, no obvious difference was observed before and after the reinfusion. (2) During the follow-up period, the efficiency and disease control rate in the study group (73.3%, 93.3%) seemed to be higher than that in the control group (67.7%, 80%),but not significantly different. There was improvement in physical strength, appetite and immunity indexes（P＜0.05）in the study group. The change in the ratio of CD4+CD25+ T cells was significant. Conclusions The autologous CIK cell therapy is safe，which improves clinical symptoms significantly in patients with RB.
关键词
CIK细胞 /
中晚期视网膜母细胞瘤 /
治疗
Key words
CIK cells /
advanced retinoblastoma /
therapy
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基金
北京市科委“首都临床特色应用研究”专项课题（Z121107001012055）
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