RESUMO
OBJECTIVE: To evaluate the effect and safety of Chinese herbal medicine Lingdankang Composite (LDK) combined dendritic cell-cytokine induced killer cells (DC-CIK) in treating leukemia. METHODS: Subjects were selected from leukemia patients who achieved hematological complete remission (HCR) but not achieved molecular biological remission (MBR), or with minimal residual leukemia (MRL) positive. Twenty patients, 19 of acute leukemia and 1 of chronic myelocytic leukemia, were enrolled. DC and CIK from patient's peripheral blood monocyte were separated respectively by blood cell separator, then DC-CIK was obtained through respective culture followed with mixed cultivation of them, and was infused back to the patient self via intravenous injection. The back infusion of DC-CIK was performed once every 15-20 days for 4-6 times in total. Meantime, LDK was administered orally every day. RESULTS: In the 20 patients treated, 4 case of HCR achieved MBR, the negatively reversed marker gene was AML1/ETO in 1 case, CBFbeta/MYH11 in 1, bcr/abl in 1, and the other 1 was IgH gene rearrangement; 3 patients with positive MRL were reversed to negative. The 3-year CR rate was 75% with a medium CR period of 25 months (10-37 months). Except transient fever and chill in 5 cases, no other remarkable adverse reaction happened during or after DC-CIK infusion. CONCLUSION: The combined treatment of LDK and autologous DC-CIK in treating patients with HCR shows an obvious effect of clearing MRL, it is the appropriate choice for curing leukemia of HCR, and is safety for intravenous infusion, so it has potential clinical prospect.
Assuntos
Células Matadoras Induzidas por Citocinas/transplante , Células Dendríticas/transplante , Medicamentos de Ervas Chinesas/uso terapêutico , Leucemia/terapia , Fitoterapia , Adolescente , Adulto , Diferenciação Celular , Células Cultivadas , Terapia Combinada , Células Matadoras Induzidas por Citocinas/citologia , Células Dendríticas/citologia , Feminino , Humanos , Leucemia/imunologia , Leucócitos Mononucleares/citologia , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
OBJECTIVE: To observe the clinical effect of Dihuang Zhixue Capsule (DZC, a Chinese preparation for cooling blood and dispelling toxic substances) in the treatment of childhood refractory idiopathic thrombocytopenic purpura (RITP), with cyclosporin A (CsA) used as the control. METHODS: Forty-one children of RITP were randomized into the treated group and the control group. The 21 patients in the treated group were orally given 2 to 3 DZC capsules each time, thrice a day and the 20 in the control group were given 3 mg/kg CsA per day, with 3 months as one therapeutic course. The therapeutic efficacy, platelet count and adverse reaction in the two groups were compared at the end of the course. RESULTS: (1) In the treated group, 1 (4.8%) patient was evaluated as cured, 3 (14.3%) as markedly effective, 5 (23.8%) as effective, 5 (23.8%) as improved, 7 (33.3%) as ineffective, with the total effective rate being 66.7%; while in the control group, the corresponding numbers were 0, 2 (10.0%), 2 (10.0%), 3 (15.0%), 13 (65.0%) and 35.0%, respectively, showing statistical significance in difference between the total effective rates of the two groups (xi(2)=4.11, P=0.0426). (2) As compared with the baseline, the platelet count increased in both groups after 2 months' treatment (P<0.05). After 3 months' treatment, the platelet count was higher in the treated group than in the control group (P<0.05). (3) The improvement of hemorrhage in the treated group after 8 weeks' treatment was better than that in the control group (P<0.05). (4) No apparent adverse reaction was observed in the treated group, while in the control group, hirsutism was shown in 15 cases; gingival hyperplasia in 10; digestive reaction in 5, liver function impairment in 5, hypertension in 2 and renal impairment in 2. CONCLUSION: The therapeutic efficacy of DZC is better than that of CsA, and DZC shows good compliance but brings no obvious adverse reaction.