解放军医学院学报2025，Vol.46Issue(10)：927-933,7.DOI:10.12435/j.issn.2095-5227.25060601
过继混合淋巴细胞免疫治疗在中老年浆细胞瘤中的长期疗效及安全性
Long-term clinical outcomes and safety of adoptive mixed lymphocyte immunotherapy in middle-aged and elderly patients with plasma cell neoplasms
摘要
Abstract
Background Plasma cell neoplasms remain incurable,with survival rates progressively declining with age.Particularly in elderly patients with multiple myeloma(MM),severe immunodeficiency and multiple comorbidities significantly worsen prognosis.There is a lack of research on long-term tolerated,gentle adoptive immunotherapy for elderly patients with plasmacytoma.Objective To investigate the long-term efficacy and safety of adoptive mixed lymphocyte(mixT)immunotherapy based on CD16 antibody pre-activation for plasma cell neoplasms.Methods This study enrolled 6 patients with plasmacytoma who received long-term regular mixT immunotherapy at the Department of Hematology,the Second Medical Center of PLA General Hospital from January 1,2009 to December 30,2024,including 4 MM cases,1 smoldering myeloma(SMM)case,and 1 case of macrofocal multiple myeloma(MFMM).MixT cells meeting quality standards were administered to patients intravenously.Infusions were performed once per month for more than 12 cycles.The phenotypes of patients'mixT cells were observed by flow cytometry,Kaplan-Meier methods were applied to plot survival curves and assess disease status,and quality of life and tumor markers before and after infusion were measured by T-test,and adverse reactions were monitored.Results Among the 6 patients,the median age at initial diagnosis was 65.5(range:52-77)years,and the median age at the last follow-up was 80.5(range:55-84)years.The median number of infusions administered was 53(range:18-189).After culture,the proportions of CD3+T cells,CD8+T cells,and NKT cells were significantly higher than those before culture.The median progression-free survival(PFS)and overall survival(OS)were not reached.As of December 30,2024,1 patient died due to disease progression,4 cases achieved complete response(CR),and 1 case achieved stringent complete response(sCR).The 2-year PFS rate was 83.3%,and the 2-year OS rate was 83.3%.After 12 courses of mixT cell infusion,patients showed improved quality of life,with a decrease in β2-microglobulin(P＜0.01).LDH showed a downward trend without significant difference.Bone destruction in 1 patient with MFMM was significantly improved after mixT therapy.Transient low-grade fever and/or fatigue occurred occasionally during infusions.Conclusion Preliminary exploration indicates that mixT,as a safe and effective adoptive immunocyte therapy,long-term mixT treatment may help middle-aged and elderly patients with plasmacytoma enhance immune function,promote disease remission,improve quality of life,alleviate bone destruction,and improve long-term prognosis.关键词
浆细胞瘤/多发性骨髓瘤/中老年/过继免疫细胞治疗Key words
plasmacytoma/multiple myeloma/middle-aged and elderly/adoptive immunotherapy分类
医药卫生引用本文复制引用
李成辉,蒲红斌,钟亚迪,吕忠霖,李泓毅,侯传东,蔡力力,范辉,郝玲波,卢学春,杨波,刘天懿,翟冰,吴亮亮,张丽君,郭搏,秦然,肖秧..过继混合淋巴细胞免疫治疗在中老年浆细胞瘤中的长期疗效及安全性[J].解放军医学院学报,2025,46(10):927-933,7.基金项目
国家自然科学基金(82450110) （82450110）
