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目的探讨过继细胞免疫疗法(ACI)治疗重型再生障碍性贫血(severe aplastic anemia,SAA)的可行性。方法对21例志愿接受新型ACI的SAA患者临床资料进行回顾性分析。对所选患者每周抽取自体20～50mL外周静脉血,分离出单核细胞后用GM-CSF和钙离子载体A23187刺激2 d后回输给患者。结果 21例SAA患者在接受ACI治疗后,7例(33.3%)在6～20个月治疗时间内达到基本治愈,1例(4.8%)在11.3个月达到缓解,4例(19.0%)在7.5～18.5个月治疗时间内达到明显进步9,例(42.9%)在6～20个月治疗时间内无效。7例基本治愈的患者出院后至2010年11月为止未见复发。1例缓解患者生产后复发。4例明显进步的患者中2例出院后1年内造血功能恢复正常,2例无明显改变。9例无效患者中有1例缓解,其他无效患者改用其他疗法也未见好转。结论 ACI目前还处于初步研究阶段,可提供分析病例较少,但从本研究证据提示新型ACI可能是一种SAA有效生物疗法。
Objective To investigate the feasibility of adoptive cell immunotherapy (ACI) in the treatment of severe aplastic anemia (SAA). Methods The clinical data of 21 SAA patients who volunteered to receive new ACI were retrospectively analyzed. Peripheral venous blood of 20 to 50 mL was taken from the selected patients weekly. Monocytes were isolated and then stimulated with GM-CSF and calcium ionophore A23187 for 2 days before being transfused into the patients. Results Seventeen patients (33.3%) were basically cured after treatment with ACI for 21 SAA patients within 6-20 months. One patient (4.8%) achieved remission at 11.3 months, and four patients (19.0% 7.5 ~ 18.5 months of treatment time to achieve significant progress 9 cases (42.9%) 6 to 20 months treatment time ineffective. Seven patients who were basically cured had no recurrence until after November 2010. One patient relieved the recurrence after production. Two of the four patients with marked improvement returned to normal within one year after discharge, with no significant changes in two cases. One of the nine ineffective patients was relieved, and the other ineffective patients did not switch to other therapies. Conclusions ACI is still in its preliminary stage of study and may provide fewer cases of analysis. However, evidence from this study suggests that novel ACI may be an effective biological therapy for SAA.