Natural killer cell therapy in children with relapsed leukemia.
Natural killer cell therapy in children with relapsed leukemia.
复制标题
复发性白血病儿童的天然杀伤细胞疗法。
DOI：
10.1002/pbc.25555
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发表时间：
2015-08
影响因子：
3.2
通讯作者：
Leung W
中科院分区：
文献类型：
--
作者：
Rubnitz JE;Inaba H;Kang G;Gan K;Hartford C;Triplett BM;Dallas M;Shook D;Gruber T;Pui CH;Leung W
复发或难治性白血病儿童需要新的治疗方法。因此，我们在该患者群体中测试了单倍体自然杀伤细胞治疗的安全性和可行性。29名复发或难治性白血病的儿童接受化疗，随后输注单倍体NK细胞。队列1包括14名未接受同种异体造血细胞移植（HCT）的儿童，而队列2包括15名在HCT后复发的白血病儿童。26例（90%）NK供者KIR不匹配（14例有1个KIR， 12例有2个KIR）。在87%的可评估受者中，NK嵌合水平达到峰值。在队列1中，10人有反应性疾病，12人随后进行了HCT。目前，有5例（36%）没有白血病。在队列2中，10例NK治疗后出现反应性疾病，并成功进行了第二次HCT。目前，有4例（27%）存活且无白血病。NK细胞输注和IL-2注射耐受良好。NK细胞治疗是安全、可行的，在化疗耐药白血病患者中应进一步研究。
Novel therapies are needed for children with relapsed or refractory leukemia. We therefore tested the safety and feasibility of haploidentical natural killer cell therapy in this patient population. Twenty-nine children who had relapsed or refractory leukemia were treated with chemotherapy followed by the infusion of haploidentical NK cells. Cohort 1 included 14 children who had not undergone prior allogeneic hematopoietic cell transplantation (HCT), whereas Cohort 2 included 15 children with leukemia that had relapsed after HCT. Twenty-six (90%) NK donors were KIR mismatched (14 with one KIR and 12 with 2 KIRs). The peak NK chimerism levels were >10% donor in 87% of the evaluable recipients. In Cohort 1, 10 had responsive disease and 12 proceeded to HCT thereafter. Currently, 5 (36%) are alive without leukemia. In Cohort 2, 10 had responsive disease after NK therapy and successfully proceeded to second HCT. At present, 4 (27%) are alive and leukemia-free. The NK cell infusions and the IL-2 injections were well-tolerated. NK cell therapy is safe, feasible, and should be further investigated in patients with chemotherapy-resistant leukemia.