NK细胞在多发性骨髓瘤ASCT围移植期的应用

doi:10.3969/j.issn.1006-6233.2017.07.025

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Abstract Objective: To observe the safety and efficacy through the application of autologous NK cells in MMASCT transplantation. Methods: 8 cases of MM patients, including 7 males and 1 female, aged 42-62 years, the median age of 51 years, before transplantation CR2 cases, PR6 cases. NK cell culture method: Membrane chimeric activity factor culture system. The pretreatment program is based on the standard melphalan or Baihuaan or fludarabine-based regimen. Two of the NK cells were transfused 6-7 days after stem cell infusion, and six of the NK cells were used as part of the transplant pretreatment program, 48 hours after chemotherapy and 24 to 48 hours before the stem cell was returned. Stem cell infusion: CD34 + cells 2.2-4.0x10 ^ 6 / kg, mononuclear cells 4.3-5.8x10 ^ 8 / kg. NK cell infusion: 16-160 * 10 ^ 6 / kg. Observe the adverse reactions, blood cell recovery time and efficacy .Results: 8 cases of fever in 6 patients, body temperature 38-39 degrees, the clinical consideration of lung infection, 1 case of oral mucositis (grade II), anti-infection symptomatic treatment after remission, no rash, diarrhea and other adverse reactions The recovery time of hematopoietic cells were as follows: granulocyte (more than 0.5 * 10 ^ 9 / L continuous 3d) 7-14d, median time 9 days, platelet (greater than 30 * 10 ^ 9 / L continuous 3d) 9-34 days Bit time 11 days. 8 patients were successfully completed ASCT. 3 months after transplantation, 3 cases of CR, 5 cases of PR. Eight patients were given thalidomide maintenance therapy. The follow-up period was 3 to 29 months, with a median follow-up of 11 months and no deaths during follow-up. Conclusion: Autologous NK cells in the MMASCT transplantation during the application, no inflammatory factor storm effect occurs, return safety, the treatment is effective. To further expand the number of cases of clinical studies to observe its long-term adverse reactions and efficacy.

Key words： NK cells Multiple myeloma Autologous hematopoietic stem cell transplantation Implant transplantation Safety

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2017.07.025 OR http://www.hbyxzzs.cn/EN/Y2017/V23/I7/1139

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