The potential of human umbilical cord mesenchymal stromal cell-derived extracellular vesicles (hucMSC-EVs) in wound healing is promising, yet a comprehensive understanding of how fibroblasts and keratinocytes respond to this treatment remains limited. This study utilizes single-cell RNA sequencing (scRNA-seq) to investigate the impact of hucMSC-EVs on the cutaneous wound microenvironment in mice. Through rigorous single-cell analyses, we unveil the emergence of hucMSC-EV-induced hematopoietic fibroblasts and MMP13+ fibroblasts. Notably, MMP13+ fibroblasts exhibit fetal-like expressions of MMP13, MMP9, and HAS1, accompanied by heightened migrasome activity. Activation of MMP13+ fibroblasts is orchestrated by a distinctive PIEZO1-calcium-HIF1α-VEGF-MMP13 pathway, validated through murine models and dermal fibroblast assays. Organotypic culture assays further affirm that these activated fibroblasts induce keratinocyte migration via MMP13-LRP1 interactions. This study significantly contributes to our understanding of fibroblast heterogeneities as well as intercellular interactions in wound healing and identifies hucMSC-EV-induced hematopoietic fibroblasts as potential targets for reprogramming. The therapeutic targets presented by these fibroblasts offer exciting prospects for advancing wound healing strategies.
BACKGROUND Currently, ongoing trials of mesenchymal stem cells (MSC) therapies for coronavirus disease 2019 (COVID-19) have been reported. AIM In this study, we investigated whether MSCs have therapeutic efficacy in novel COVID-19 patients. METHODS Search terms included stem cell, MSC, umbilical cord blood, novel coronavirus, severe acute respiratory syndrome coronavirus-2 and COVID- 19, applied to PubMed, the Cochrane Controlled Trials Register, EMBASE and Web of Science. RESULTS A total of 13 eligible clinical trials met our inclusion criteria with a total of 548 patients. The analysis showed no significant decrease in C-reactive protein (CRP) levels after stem cell therapy ( P = 0.11). A reduction of D-dimer levels was also not observed in patients after stem cell administration (P = 0.82). Furthermore, interleukin 6 ( IL-6) demonstrated no decrease after stem cell therapy (P = 0.45). Finally, we investigated the overall survival (OS) rate after stem cell therapy in COVID-19 patients. There was a significant improvement in OS after stem cell therapy; the OS of enrolled patients who received stem cell therapy was 90.3%, whereas that of the control group was 79.8% (P = 0.02). CONCLUSION Overall, our analysis suggests that while MSC therapy for COVID-19 patients does not significantly decrease inflammatory markers such as CRP, D-dimer and IL-6, OS is improved.
The stem cell biology plays an important role in the application and research of the clinical medicine and biology. The breakthrough of the therapies for a variety of human diseases depends on the rapid growth of stem cell biology. It is of great significance to set up graduate curriculum of stem cell biology in the medical college. This article elaborates the design and implementation of the course of Stem Cell Biology including the selection of the teaching materials, design of course outline, teaching content, evaluation methods, teaching introspection and other aspects, thus providing references and communications in this field.
随着医学技术的不断进步和科学研究的不断深入,肿瘤免疫细胞治疗作为一种新的治疗方式受到社会各界的广泛关注,成为辅助肿瘤治疗的一种新手段.过继免疫细胞治疗相继出现了不同类型的细胞——T淋巴细胞、细胞因子诱导的杀伤(CIK)细胞、树突状细胞(DC)-CIK细胞、自然杀伤(NK)细胞和肿瘤浸润性淋巴细胞(TIL)细胞等.日前开展的多种类型的免疫细胞临床研究在肿瘤治疗中已经体现出显著的疗效,肿瘤免疫治疗成为快速发展的研究领域.如何选择肿瘤免疫细胞治疗方法和时机,治疗过程中的质量控制和质量管理应当怎么做,如何得到更有说服力的循证医学证据,是值得深入探索的重要问题.对目前的肿瘤免疫细胞治疗现状和未来5年发展做一概述,初步探讨临床研究中的质量控制和质量管理方向.
目的:利用CRISPR/Cas9基因编辑技术构建CDH1基因缺失的人乳腺癌MCF-7稳定细胞系.方法:根据CRISPR/Cas9靶点设计原则,设计能特异性针对CDH1基因的sgRNA,以lentiCRISPR v2质粒为骨架构建能表达此sgRNA和Cas9蛋白的重组质粒.测序鉴定后,将重组质粒与逆转录病毒包装质粒VSVG、PAX2在氯化钙介导下共同转入HEK293T细胞进行病毒包装,转染48 h后收集病毒上清,直接感染人乳腺癌MCF-7细胞.采用嘌呤霉素筛选CDH1缺失的乳腺癌MCF-7细胞,通过DNA测序、Western印迹及免疫荧光染色实验验证获得的MCF-7细胞.结果:构建了靶向CDH1的CRISPR/Cas9质粒;DNA测序和Western印迹实验结果表明获得了稳定敲除CDH1的人乳腺癌MCF-7细胞.免疫荧光染色结果显示,相比对照组,稳定敲除CDH1的MCF-7细胞中已无法明显观察到E-钙黏蛋白的表达分布.结论:通过CRISPR/Cas9基因编辑技术构建了CDH1基因缺失的MCF7细胞系,为进一步研究CDH1在肿瘤免疫治疗中的作用提供了基础.
To evaluate the therapeutic efficacy of passive cellular immunotherapy for glioma, a total of 979 patients were assigned to the meta-analysis. PubMed and the Cochrane Central Register of Controlled Trials were searched initially from February 2018 and updated in April 2019. The overall survival (OS) rates and Karnofsky performance status (KPS) values of patients who underwent passive cellular immunotherapy were compared to those of patients who did not undergo immunotherapy. The proportion of survival rates was also evaluated in one group of clinical trials. Pooled analysis was performed with random-or fixed-effects models. Clinical trials of lymphokine-activated killer cells, cytotoxic T lymphocytes, autologous tumor-specific T lymphocytes, chimeric antigen receptor T cells, cytokine-induced killer cells, cytomegalovirus-specific T cells, and natural killer cell therapies were selected. Results showed that treatment of glioma with passive cellular immunotherapy was associated with a significantly improved 0.5-year OS (p = 0.003) as well as improved 1-, 1.5-, and 3-year OS (p = 0.05). A meta-analysis of 206 patients in one group of clinical trials with 12-month follow-up showed that the overall pooled survival rate was 37.9% (p = 0.003). Analysis of KPS values demonstrated favorable results for the immunotherapy arm (p < 0.001). Thus, the present meta-analysis showed that passive cellular immunotherapy prolongs survival and improves quality of life for glioma patients, suggesting that it has some clinical benefits.
Gene editing is a genetic engineering technology that can modify, delete, or insert a small piece of DNA at a specific point in the genome of cells and organisms. Gene editing technology holds great promises in the fields of disease treatment, gene function regulation, gene detection, drug research and development, and crop breeding. However, side effects, such as off-target editing, genotoxicity and other issues, have gradually emerged in the application. In the CRISPR (clustered regularly interspaced short palindromic repeats) system, the Cas9 nuclease can specifically recognize the target DNA by the base pairing of a guide RNA (gRNA) with the target DNA. Upon target recognition, the two DNA strands are cleaved by distinct domains of the Cas9 nuclease. Since both Cas9 nuclease and gRNA possess different characteristics in their own activities, recognition sites and binding ability to specific target, it is essential to precisely regulate the activity of Cas9 nuclease and gRNA in both time and space manners, thus preventing the risk of side effects and enhancing the precise regulation of the CRISPR/Cas9 gene editing technology. In this review, we summarize the advances in the precise control of gene editing, especially CRISPR/cas9 over several dimensions using fusion Cas9 proteins regulated by light, temperature and drugs, exploiting and screening anti-CRISPRs proteins, synthesizing and identifying small molecules- inhibitors, and developing other therapeutic agents, thereby providing a reference and research ideas for human disease treatment, crop and livestock improvement and prevention of biotechnology misuse.
Our objective was to summarize the side effect of chimeric antigen receptor (CAR)-T cell therapy in patients with acute lymphocytic leukemia (ALL) and lymphoma. Two independent reviewers extracted relevant data. A total of 35 hematologic malignancy studies with CD19 CAR-T cell were included (1412 participants). Severe cytokine release syndrome (sCRS) proportion was experienced by 18.5% (95% confidence interval [CI], 0.128-0.259; P = 0.000) of 982 patients with the National Cancer Institute/Lee/common terminology criteria for adverse events grading system. The pooled neurotoxicity proportion was 21.7% (95% CI, 0.167-0.287; P = 0.000) of 747 patients with the same grading system. For all of the 25 clinical trials with the same grading system, subgroup analysis was performed. Based on the different disease type, a pooled prevalence of 35.7% was observed with event rate (ER) of 0.358 (95% CI, 0.289-0.434; P = 0.000) for ALL in 12 clinical trials. For lymphoma, a pooled prevalence of 13% was observed with ER of 0.073 (95% CI, 0.028-0.179; P = 0.000) in eight clinical trials. It was demonstrated that the patients who were older than 18 years of age have the lower sCRS incidence of 16.1% (95% CI, 0.110-0.250; P = 0.000) compared with 28.6% of the remaining population who were younger than 18 years of age (95% CI, 0.117-0.462: P = 0.023) in our analysis. Based on the different co-stimulatory domain, the sCRS of 16.5% was observed with ER of 0.175 (95% CI, 0.090-0.312; P = 0.000) for 4-1BB. The sCRS of 22.2% was observed with ER of 0.193 (95% CI, 0.107-0.322; P = 0.000) for CD28. For both the CD28 and 4-1BB, the sCRS of 17.3% was observed with ER of 0.170 (95% CI, 0.067-0.369; P = 0.003). Sub-analysis sCRS of the impact with cell dose and specific disease indication were also demonstrated. Limitations include heterogeneity of study populations, as well as high risk of bias of included studies. These results are helpful for physicians, patients and the other stakeholders to understand the adverse events and to further promote the improvement of CAR-T cell therapy in the future. (C) 2020 International Society for Cell and Gene Therapy. Published by Elsevier Inc. All rights reserved.
随着人口老龄化加快,与衰老相关疾病的经济负担不断加重,有关衰老问题的研究受到了前所未有的重视.然而,现有衰老评估的研究虽从分子生物学、临床医学、流行病学等方面取得了不少成果,但由于评估形式繁杂、内容多样、标准各异、缺乏敏感的生物学标志物等问题,仍面临很多困难.为此,本文概述了衰老评估方法以及目前衰老评估常用和新兴生物标志物的研究进展.
主要论述《临床试验通用稽查标准》起草背景、目的、制定依据、适用范围、稽查内容与标准、稽查发现问题分级定义等,以期进一步完善临床试验质量管理体系,通过临床试验通用稽查标准的建立与执行,规范临床试验稽查工作,进而促进临床试验领域从业人员工作自律,规范临床试验过程,确保临床试验数据真实、结果可靠,加速我国临床试验研究的国际化进程,提升行业临床试验稽查水平和临床试验能力.
Immunotherapy with chimeric antigen receptor T (CAR-T) cells has proved remarkably effective in recently published clinical trials. In this meta-analysis, we performed a systematic review in terms of the clinical response treated with CAR-T cells in acute lymphoblastic leukemia (ALL), chronic lymphocytic leukemia (CLL) and lymphomas patients. Thirty-eight published clinical studies including 665 patients were eligible for response rate (RR) evaluation. The overall pooled RR of CD19-CAR-T cells was 72% (95% confidence interval: 62-77%). The various clinical parameters were analyzed. RR was 81% in ALL, 68% in lymphoma and 70% in CLL. RR in patients who received interleukin (IL)-2 was 70%, whereas in those who did not receive IL-2, it was 74%. RR was 75% with lymphodepletion and 56% without lymphodepletion. RR with autologous cells was 76% and 57% with allogeneic cells. In conclusion, this meta-analysis showed a high clinical RR of CD19-CAR-T cell-based immunotherapy in patients with refractory B-cell malignancies.
嵌合抗原受体T (chimeric antigen receptor T,CAR-T)细胞治疗近年来发展迅速,已在某些血液系统的恶性肿瘤治疗中取得了惊人的疗效,但在实体肿瘤的治疗中进展不大.目前在CAR-T细胞治疗中需要解决的问题主要有:(1)增强CAR-T细胞的杀伤活性;(2)解除肿瘤免疫抑制状态;(3)使CAR-T细胞进入实体瘤;(4)增强CAR-T细胞治疗的安全性.通过CAR结构的优化设计,可以克服CAR-T细胞治疗中的一系列缺陷,增强CAR-T细胞的疗效和减缓并发症的发生.本文对近年来在CAR结构设计上的一些优化改进措施及方法进行总结分析,探索提高CAR-T细胞治疗过程中有效性和安全性的策略和措施.
OBJECTIVE:To investigate the therapeutic potential of adipose-derived stem cells (ADSCs) for limited cutaneous scleroderma (LS) in mouse models. METHODS:ADSCs were isolated from pathogen-free female C57BL/6 mice and LS was induced in wild type (WT) C57BL/6 mice via daily injection of bleomycin (0.1 mL × 300 μg/mL) for 4 weeks; then the ADSCs were subcutaneously injected into the dorsal area in the model treatment group, and 100 μL of phosphate-buffered saline (PBS) solution was injected into the same site in the model control group. Green fluorescent protein (GFP) was used to track the cells using an in vivo imaging system on days 7, 14, 21, and 28 after transplantation. All mice were sacrificed and histologic analyses were performed after 4 weeks, and the skin thickness, collagen deposition and the total content of hydroxyproline were evaluated. Additionally, immunohistochemistry were performed to compare the tissue expression and distribution of TGF-β1 and VEGF between the ADSCs treatment group and the treatment control group. RESULTS:WT C57BL/6 LS mouse model were successfully established and GFP in vivo fluorescence imaging showed that the translated ADSCs survived at the local for at least 4 weeks. Compared with the control group, the ADSCs treatment group significantly attenuated bleomycin-induced dermal fibrosis, reduced the skin thickness and the total content of hydroxyproline (P < 0.05). The ADSCs treatment group displayed significantly lower levels of TGF-β1 and higher levels of VEGF than the control group (P < 0.05). CONCLUSIONS:ADSCs may provide a feasible and practical treatment for autoimmune diseases such as LS and ameliorate dermal fibrosis.
Background: Stem cell transplantation is an emerging therapeutic option for type 1 diabetes (T1D). Here, we explored the therapeutic efficacy of stem cell treatment for T1D by meta-analysis. Methods: The search strategy included the following keywords: stem cell; haematopoietic stem cell (HSC); mesenchymal stem cell (MSC); cord blood stem cell (UBSC); and T1D. These were used to search the following databases: MEDLINE; the Cochrane Controlled Trials Register; EMBASE; the Wanfang Database; the China Science and Technology Periodical Database; and China Journal Net. Results: 32 eligible clinical trials met our inclusion criteria with a total of 712 patients including 405 males. Glycosylated haemoglobin (HbA1c) was decreased following stem cell therapy in patients with T1D (12 month: P<0.001; 9 month: P=0.0003; 6 month: P<0.001; 3 month: P<0.001). Moreover, after the 15-, 18-, 21- and 24-months long-term follow up, HbA1c still showed significant decreases (24 month: P=0.002; 21 month: P=0.002; 18 month: P<0.001; 15 month: P=0.0003). Meanwhile, C-peptide levels increased following stem cell therapy (12 month: P<0.001; 9 month: P<0.001; 6 month: P<0.001; 3 month: P<0.001) and also demonstrated benefits after long-term follow up (24 month: P<0.001; 18 month: P<0.001). Insulin requirements were also reduced in patients receiving stem cell therapy (3 and 6 months: P<0.001). The glutamic acid decarboxylase antibody (GAD-Ab) titer showed no decrease after the stem cell therapy in T1D at the 6 and 12 months follow up (P>0.05). Lastly, we investigated the immune function of regulatory T cells (Treg) and CD4(+)/CD8(+) after the stem cell therapy in T1D. The analysis showed no significant decrease with Treg and CD4(+)/CD8(+) at the 6 and 12 month follow up (P>0.05). Conclusions: Our meta-analysis of clinical trials suggests that stem cell therapy for T1D provides a sustained improvement in glycaemic control, enhanced the endogenous insulin production and the regeneration of beta-cells, and maintained complete or very good partial responses for a long time. Thus, stem cell therapy provides a promising cell replacement therapy for T1D.
BACKGROUND AIMS:In this study, we investigate whether bone marrow mononuclear cells (BM-MNC) or peripheral blood mononuclear cells (PB-MNC) have therapeutic efficacy in type 2 diabetes (T2D).METHODS:Search terms included stem cell, bone marrow cell, peripheral blood cell, umbilical cord blood and T2D in MEDLINE, the Cochrane Controlled Trials Register, EMBASE, the Wanfang Database, the China Science and Technology Periodical Database and China Journal Net.RESULTS:Fifteen trials met our inclusion criteria (n = 497). One group included 266 cases with BM-MNC therapy and the other group contained 231 cases with PB-MNC treatment. Glycosylated hemoglobin was decreased after BM-MNC or PB-MNC therapy compared with that before (12 months: P < 0.001; 6 months: P < 0.001; 3 months: P < 0.05). Fasting plasma glucose was reduced in BM-MNC therapy group compared with control after 12-month follow-up (P < 0.001) and after BM-MNC therapy compared with that before (9 months: P < 0.001) but was not obvious in other stages. Meanwhile, the analysis showed that C-peptide level increased after BM-MNC and PB-MNC therapy compared with the control therapy (12 months: P < 0.001) and with that before therapy (6 months: P < 0.05). Insulin requirement reduction was also observed in patients receiving BM-MNC therapy (3, 6, 9 and 12 months: P < 0.05).CONCLUSIONS:To a certain extent, BM-MNC or PB-MNC therapy for T2D demonstrated superiority of glycemic control, increased insulin biosynthesis and elevated insulin secretion from existing β-cells and might prevent islet cell loss.
OBJECTIVES:Our meta-analysis performed a systematic evaluation on the therapeutic efficacy and safety of tumour vaccines for the treatment of advanced non-small cell lung cancer (NSCLC).DESIGN:Systematic review and meta-analysis of randomised controlled trials (RCT).DATA SOURCES:PubMed, the Cochrane Center Register of Controlled Trials, Science Direct and EMBASE were searched from January 1980 until January 2015.ELIGIBILITY CRITERIA FOR SELECTING STUDIES:RCT were included; the control arm had to receive either placebo or chemotherapy or no treatment.MAIN OUTCOME MEASURES:The quality of the data from individual papers was assessed for overall survival (OS), clinical response rate and side effects.RESULTS:Overall, 11 RCT of advanced NSCLC with a total of 3986 patients were conducted for meta-analysis. The results showed that the vaccine arm significantly extended primary endpoint median overall survival compared with control group (p<0.00001) (HR 0.760; 95% CI 0.644 to 0.896; p=0.001). Three subgroup patients with tumour vaccine at 1-year, 2-year and 3-year survival rates also gained significant benefits compared with their corresponding control group (p=0.0004, 0.03 and 0.19, respectively). Besides, a significant improvement in median time to progression (TTP), median progression-free survival (PFS) and a trend of improvement in objective response rate were observed after tumour vaccine treatment (p=0.001, 0.005 and 0.05, respectively; median PFS HR 0.842; 95% CI 0.744 to 0.954; p=0.007). A few severe adverse effects occurred in the tumour vaccine group, but fewer side effects were observed in the vaccine group compared with the control group (p<0.00001).CONCLUSIONS:Taken together, NSCLC tumour vaccines markedly prolong median OS (p<0.00001), median TTP (p=0.001) and median PFS (p=0.005), improve clinical response rate (p=0.05) and lessen adverse side effects (p<0.00001). Our meta-analysis suggests tumour vaccines improve the efficacy of the treatment, and also provide superiority in treatment of patients with advanced NSCLC among a variety of immunotherapy strategies.
Background aims The aim of this study was to investigate whether active specific immunotherapy (ASI) is able to demonstrate therapeutic efficacy against colorectal cancer. Methods We conducted a systematic review of published papers from MEDLINE, the Cochrane Central Register of Controlled Trials, EMBASE, the Wanfang Database, the China Science and Technology Periodical Database and China Journal Net. Published data were extracted independently by two authors who used predefined database templates. The effects of ASI were compared with those of surgery alone, and a pooled analysis was performed with the use of the data from random- or fixed-effect models. Results Twelve trials matched our inclusion criteria (n = 2993, including 1842 control subjects). The overall analysis showed a significant survival benefit [1-, 2-, 3-, 4-, 5-, 6- and 7-year overall survival (OS), P < 0.05; 10-year OS, P < 0.001] in favor of ASI immunotherapy combined with surgery, but there was not an improvement in the 8- or 9-year OS (P > 0.05). The disease-free survival (DFS) rate was improved after the combination of ASI immunotherapy (2-, 3-, 5- and 10-year DFS, P < 0.05), but no significant improvement was noted for the 1-, 4-, 6-, 7-, 8- or 9-year DFS (P > 0.05). In addition, the disease-specific survival (DSS) was improved at some time points after the combination of ASI immunotherapy and surgery (2-, 3-, 4-, 5- and 6-year DSS, P < 0.05, but not the 1-, 7-, 8- or 9-year DSS, P > 0.05). An improved 2-, 3-, 4-, 5- and 6-year recurrence-free interval (RFI) (P < 0.05) was also observed in patients who received ASI therapy, but this was not observed for the 1-year RFI (P > 0.05). Furthermore, an analysis of the recurrence-free survival (RFS) showed that it was significantly increased in the ASI plus surgery group (1-, 2-, 3-, 4-, 5- and 6-year RFS, P < 0.001). The funnel plots showed that the analyses were relatively reliable and the publication bias was small. Conclusions The combination of ASI immunotherapy and surgery was superior in prolonging the overall survival time and enhancing the recurrence-free survival rate compared with surgery alone.
Aim: Peripheral arterial disease (PAD), particularly critical limb ischemia (CLI), is a severe cause of amputation and mortality. More than 50% of diabetic patients with CLI die within four to five years. The development of novel stem cell therapies may bring new hope to these patients. We aimed to assess the efficacy of autologous bone marrow cell therapy for treating CLI using a meta-analysis.Methods: We searched the literature in PubMed, the Cochrane Central Registry of Controlled Trials, the Elsevier database and EBSCO for trials of autologous cell therapy in patients with severe PAD published before October 30, 2013. We chose objective clinical endpoints to assess the efficacy of therapy in the meta-analysis, including changes in the ankle-brachial index (ABI), transcutaneous oxygen tension (TcO2), pain scale (0-10 scale) and amputation-free survival (AFS).Results: Thirty-one articles reporting clinical trials involving a total of 1,214 patients treated with bone marrow stem cell-based therapy were collected for the meta-analysis, in which the randomized controlled trials (RCTs) and other trials (non-RCTs) were classified into two groups. Regarding the efficacy of stem cell therapy, the ABI showed significant increases (P<0.05) at 12, 24 and 48 weeks after therapy in the non-RCT and RCT groups, but not after four to eight weeks in the non-RCT group. The TcO2 values also increased in the RCT group at four to eight weeks after therapy and 24 weeks after therapy (P<0.001) and in the non-RCT group at four to eight weeks after therapy (P=0.01), although no significant increases were observed in the RCT group at 12 weeks after therapy or the non-RCT group at 24 weeks after therapy. Meanwhile, pain was significantly reduced (P<0.05) at four to eight weeks and 24 weeks after therapy in both the non-RCT and RCT groups, but not at four to eight weeks or 12 weeks after therapy in the RCT group. In addition, the long-term clinical trials demonstrated that the AFS rate improved after therapy with bone marrow stem cells (one-year AFS, P<0.00001; three-year AFS, P=0.0003).Conclusions: The present results suggest that autologous bone marrow stem cells have an advantageous therapy effect in PAD patients who are not eligible for revascularization.
AIMTo investigate whether autologous dendritic cell (DC)-cytokine-induced killer (CIK) cell therapy is able to improve the therapeutic efficacy of chemotherapy in colon cancer.METHODSWe conducted a systematic review of published papers from the sources of MEDLINE, the Cochrane Central Register of Controlled Trials, EMBASE, the Wanfang Database, the China Science and Technology Periodical Database and China Journal Net. Published data were extracted independently by two authors using predefined database templates. The quality of the data from individual papers was also assessed. The effects of chemotherapy were compared with those of chemotherapy in combination with DC-CIK immunotherapy. The pooled analysis was performed using the data from random or fixed-effect models.RESULTSSeven trials matched our inclusion criteria (n = 533). The overall analysis showed significant survival benefit [one-year overall survival (OS), P < 0.0001; two-year OS, P = 0.009; three-year OS, P = 0.002] in favor of DC-CIK immunotherapy combined with chemotherapy. Disease-free survival (DFS) rate was improved after the combination of DC-CIK immunotherapy and chemotherapy (one-year DFS, P < 0.0001; two-year DFS, P = 0.002; three-year DFS, P = 0.02). An improved overall response rate (P = 0.009) was also observed in patients who received DC-CIK therapy. Furthermore, the analysis of T-lymphocyte subsets in peripheral blood indicated that the number of CD4⁺ T cells significantly increased in the DC-CIK plus chemotherapy group (P < 0.05).CONCLUSIONThe combination of DC-CIK immunotherapy and chemotherapy was superior in prolonging the survival time and enhancing immunological responses.