中国实验血液学杂志2024,Vol.32Issue(2) :445-449.DOI:10.19746/j.cnki.issn1009-2137.2024.02.019

小剂量重组人白细胞介素-2维持治疗对肿瘤患儿免疫细胞亚群的影响

Effect of Low-Dose Recombinant Interleukin-2 Therapy on Immunocyte Subsets in Children with Solid Tumor

雷嘉颖 黎阳 李春谋 熊稀霖 冯楚础 翁文骏 彭晓敏 周敦华 黄科
中国实验血液学杂志2024,Vol.32Issue(2) :445-449.DOI:10.19746/j.cnki.issn1009-2137.2024.02.019

小剂量重组人白细胞介素-2维持治疗对肿瘤患儿免疫细胞亚群的影响

Effect of Low-Dose Recombinant Interleukin-2 Therapy on Immunocyte Subsets in Children with Solid Tumor

雷嘉颖 1黎阳 1李春谋 1熊稀霖 1冯楚础 1翁文骏 1彭晓敏 1周敦华 1黄科1
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作者信息

  • 1. 中山大学孙逸仙纪念医院儿童医学中心肿瘤科,广东广州 510120
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摘要

目的:探讨小剂量重组人白介素-2(rIL-2)维持治疗对恶性实体肿瘤患儿免疫细胞亚群的影响及相关副反应.方法:选取2012年12月-2017年11月在本科治疗的22例肿瘤患儿,男女各11例,开始IL-2治疗的中位年龄9(3-16)岁,给予小剂量rIL-2免疫治疗前均完成全部手术及放化疗,其中完全缓解17例,部分缓解5例.化疗结束1个月后开始使用rIL-2小剂量维持治疗:4×105 IU/(m2·d),隔日皮下注射,每周3次,共1年.每3个月行免疫细胞亚群检测至治疗终止,同时随访患儿病情转归及治疗相关副反应.结果:22例患儿经rIL-2治疗后外周血T淋巴细胞(CD3+)、自然杀伤细胞(CD3-CD56+)、辅助性T细胞(CD3+CD4+)、杀伤性T细胞(CD3+CD8+)的绝对值及辅助T细胞/抑制T细胞比例均显著升高(均P<0.05),而调节性T细胞(CD4+CD25+CD127-)治疗前后的绝对值及比例无显著性差异(P>0.05).在治疗前获得完全缓解的17例患儿中,14例在治疗后继续保持完全缓解,3例复发,其中2例放弃治疗后死亡;治疗前获得部分缓解的5例患儿经治疗后行PET/CT扫描后评估为完全缓解.在小剂量rIL-2免疫治疗初期,出现注射部位皮疹1例,注射后低至中度一过性发热2例,均给予对症处理后消失,未见治疗相关器官功能损害.结论:小剂量rIL-2维持治疗耐受性良好,可显著改善肿瘤患儿外周血部分抗肿瘤免疫细胞亚群的分布,且不会导致调节性T细胞绝对值及比例的升高.

Abstract

Objective:To evaluate the effect of low-dose recombinant interleukin-2(rIL-2)therapy on immunocyte subsets and its side effects in children with solid tumor.Methods:A total of 22 children(11 males and 11 females)with solid tumor in our department from December 2012 to November 2017 were selected,with a median age of 9(3-16)years old when starting IL-2 therapy.ALL surgeries and chemotherapy of children had been completed before low-dose rIL-2 therapy,and 17 cases achieved complete remission(CR)and 5 cases achieved partial remission(PR).A low-dose rIL-2 therapy was given 1 month after chemotherapy for 1 year:4 × 105 IU/(m2·d),s.c.for every other day,3 times per week.The immunocyte subsets were detected every 3 months until the end of treatment,meanwhile,disease condition and therapy-related side effects were followed up.Results:After low-dose rIL-2 therapy in 22 children,the absolute values of CD3+T cells,CD3-CD56+natural killer cells,CD3+CD4+helper T cells(Th)and CD3+CD8+cytotoxic T cells were up-regulated remarkably,as well as Th/suppressor T cells(all P<0.05).While,there were no significant differences in absolute value and proportion of CD4+CD25+CD127-Treg cells during therapy.Among the 17 children who achieved CR before rIL-2 therapy,14 cases continued to maintain CR after therapy,while 3 cases relapsed,and with 2 died after treatment abandonment.The 5 children who achieved PR before low-dose rIL-2 therapy were evaluated CR by PET/CT scan after treatment.In the early stage of low-dose rIL-2 therapy,1 child developed skin rashes at the injection sites,and 2 children ran a slight to mild transient fever.Their symptoms disappeared without any organ damage after symptomatic treatment.Conclusion:Low-dose rIL-2 therapy has good drug tolerance,and changes the distribution of anti-tumor immune-cell subgroup in peripheral blood of children with solid tumor remarkably without up-regulation of absolute value and ratio of Treg cells.

关键词

重组人白介素2/儿童/实体瘤/免疫细胞/调节性T细胞

Key words

recombinant interleukin-2/children/solid tumor/immune cell/Treg

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出版年

2024
中国实验血液学杂志
中国病理生理学会

中国实验血液学杂志

CSTPCDCSCD北大核心
影响因子:0.988
ISSN:1009-2137
参考文献量28
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