Combination Of Adoptive Cellular Immunotherapy And Bortezomib-based Regimens For The Treatment Of Multiple Myeloma

Objective: Previous studies shows that Bortezomid can enhance the sensitivity ofmultiple myeloma (MM) cell for γδT, NK and CIK killing and there is synergistic effectamong these three types of cells. In this study, to detect combination of NK, γδT and CIKbased adoptive cellular immunotherapy (ACI) and Bortezomib-based regimens for theprogression free survival(PFS) and early objective response rate of multiple myeloma.Method: Collect the clinical materials of27patients firstly diagnosed with multiplemyeloma and receiving Bortezomid-based therapy during September2008and September2013. The patients were divided into study group(ACI plus Bortezomid-based therapy) andcontrol group(only Bortezomid-based therapy) according to the use of ACI. There are14ptsin study group with median age60.5(54-73), while13pts in control group with median age56(41-80).For subgroup analysis, the patients having received the combination therapy weredivided into≤3course group and>3course group. The objective response rate during firstfour courses and PFS were compared between different group.Result: In this study, the percentage of CIK (CD56+CD3+),NK (CD56+CD3-) and γδT(Vγ9+) before and after induction were4.39%(1.5%-8%) vs46.32%(27%-50%),10.35%(5.1%-12.6%) vs95.28%(70.1%-99.6%),4.72%(2.61%-11.2%) vs90.64%(60.5%-97.9%),respectively. The median follow up time was18months. Age, gender, tumor stage, badkaryotype and/or molecular biomarker, and auto-stem cell transplant had no significantdifference between two groups. The median PFS in study group was24.5m (12-48), and themedial PFS was12m (5-32) in control group. There was significant difference (P=0.018). Forsubgroup analysis, the median PFS in>3course group and≤3course group was36m(24-48)and20m(12-36), respectively. No significant difference was found (P=0.141). Conclusion: Combination of NK, γδT and CIK based ACI and Bortezomib-basedregimens can improve the PFS of multiple myeloma significantly, and increasing courses mayfurther improve the PFS.It is probably that early combination of ACI can improve theobjective response rate. But more samples and prospective trial are urgently needed forpersuasive conclusions.