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.
题目: 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.
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。.
Keywords: Treg; children; immune cell; recombinant interleukin-2; solid tumor.