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Intorduction

Multiple Myeloma

Multiple myeloma (MM) is a malignant plasma cell disease in which tumor cells originate from plasma cells in the bone marrow, and plasma cells are cells that develop to the final stage of function of B lymphocytes. Therefore, multiple myeloma can be classified as B lymphocyte lymphoma. The WHO currently classifies it as a type of B-cell lymphoma, called plasma cell myeloma/plasma cell tumor. It is characterized by abnormal proliferation of bone marrow plasma cells accompanied by excessive production of monoclonal immunoglobulin or light chain (M protein). Very few patients may be unsecreted MM that does not produce M protein. Multiple myeloma is often accompanied by multiple osteolytic damage, hypercalcemia, anemia, and kidney damage. Since the production of normal immunoglobulin is inhibited, various bacterial infections are prone to occur. The incidence is estimated to be 2 to 3/100,000, and the male to female ratio is 1.6:1. Most patients are older than 40 years old.

Symptoms


Anemia, bone pain, renal insufficiency, infection, bleeding, neurological symptoms, hypercalcemia, amyloidosis



Limb paralysis, lethargy, coma, diplopia, blindness, loss of vision



Liver and spleen enlargement, cervical lymph nodes enlargement, myeloma kidney



Hemodialysis fistula tube infarction, deep vein thrombosis or myocardial infarction, etc.


ACTL Treatment Plan

After determining the indications for ACTL treatment of patients in accordance with the "Screening Criteria for Cancer Patients", the specific ACTL treatment plan should be determined according to the specific conditions of the patient, such as the patient's condition, receiving radiotherapy and chemotherapy, and the following principles should be mastered:

1. The patient should have blood routine, liver and kidney function, relevant serum tumor markers (tumor antigen or tumor-related antigen) laboratory test and imaging examination results.

2. During ACTL treatment, in addition to treatments that damage immune function or bone marrow suppression, patients can receive other anti-tumor treatments.

3. The number of antigen-specific cytotoxic T Iymphocytes (CTL) of patients who are reinfused in each treatment should be ≥1*108

4. For patients with allergies or elderly and infirm, when CTL is reinfused, a small dose of dexamethasone can be considered.

5. Clinical therapeutic grade interleukin 2 (IL-2): At the same time as CTL is reinfused, intravenous infusion of IL-2 is recommended to adjust the patient's immune function, prolong the activity of CTL in the body, and improve the efficiency of killing tumor cells. For the first reinfusion, the recommended dose is 500,000 units to observe the patient's tolerance to IL-2. If the patient has no obvious adverse reactions or allergic reactions, from the second ACTL treatment, 1 to 2 million units of IL-2 will be given each time CTL is infused. It is not recommended to use my country's SFDA approved for clinical treatment

After determining the indications for ACTL treatment of patients in accordance with the "Screening Criteria for Cancer Patients", the specific ACTL treatment plan should be determined according to the specific conditions of the patient, such as the patient's condition, receiving radiotherapy and chemotherapy, and the following principles should be mastered:

1. The patient should have blood routine, liver and kidney function, relevant serum tumor markers (tumor antigen or tumor-related antigen) laboratory test and imaging examination results.

2. During ACTL treatment, in addition to treatments that damage immune function or bone marrow suppression, patients can receive other anti-tumor treatments.

3. The number of antigen-specific cytotoxic T Iymphocytes (CTL) of patients who are reinfused in each treatment should be ≥1*108

4. For patients with allergies or elderly and infirm, when CTL is reinfused, a small dose of dexamethasone can be considered.

5. Clinical therapeutic grade interleukin 2 (IL-2): At the same time as CTL is reinfused, intravenous infusion of IL-2 is recommended to adjust the patient's immune function, prolong the activity of CTL in the body, and improve the efficiency of killing tumor cells. For the first reinfusion, the recommended dose is 500,000 units to observe the patient's tolerance to IL-2. If the patient has no obvious adverse reactions or allergic reactions, from the second ACTL treatment, 1 to 2 million units of IL-2 will be given each time CTL is infused. It is not recommended to use my country's SFDA approved for clinical treatment

After determining the indications for ACTL treatment of patients in accordance with the "Screening Criteria for Cancer Patients", the specific ACTL treatment plan should be determined according to the specific conditions of the patient, such as the patient's condition, receiving radiotherapy and chemotherapy, and the following principles should be mastered:

1. The patient should have blood routine, liver and kidney function, relevant serum tumor markers (tumor antigen or tumor-related antigen) laboratory test and imaging examination results.

2. During ACTL treatment, in addition to treatments that damage immune function or bone marrow suppression, patients can receive other anti-tumor treatments.

3. The number of antigen-specific cytotoxic T Iymphocytes (CTL) of patients who are reinfused in each treatment should be ≥1*108

4. For patients with allergies or elderly and infirm, when CTL is reinfused, a small dose of dexamethasone can be considered.

5. Clinical therapeutic grade interleukin 2 (IL-2): At the same time as CTL is reinfused, intravenous infusion of IL-2 is recommended to adjust the patient's immune function, prolong the activity of CTL in the body, and improve the efficiency of killing tumor cells. For the first reinfusion, the recommended dose is 500,000 units to observe the patient's tolerance to IL-2. If the patient has no obvious adverse reactions or allergic reactions, from the second ACTL treatment, 1 to 2 million units of IL-2 will be given each time CTL is infused. It is not recommended to use my country's SFDA approved for clinical treatment

  • I. Patients with stage II tumors

    1. Patients who are receiving radiotherapy and chemotherapy are not recommended to receive ACTL treatment at the same time;

    2. For patients who are going to receive radiotherapy or chemotherapy, consider the following ACTL treatment plan, but pay attention to the obvious decline in the number of white blood cells or bone marrow suppression, and stop ACTL treatment;

    1. Patients who are receiving radiotherapy and chemotherapy are not recommended to receive ACTL treatment at the same time;

    2. For patients who are ready to receive radiotherapy or chemotherapy, consider the following ACTL treatment plan, but pay attention to the obvious decline in the number of white blood cells or bone marrow suppression, and stop ACTL treatment;

    1. Patients who are receiving radiotherapy and chemotherapy are not recommended to receive ACTL treatment at the same time;

    2. For patients who are going to receive radiotherapy or chemotherapy, consider the following ACTL treatment plan, but pay attention to the obvious decline in the number of white blood cells or bone marrow suppression, and stop ACTL treatment;

    1. Patients who are receiving radiotherapy and chemotherapy are not recommended to receive ACTL treatment at the same time;

    2. For patients who are going to receive radiotherapy or chemotherapy, consider the following ACTL treatment plan, but pay attention to the obvious decline in the number of white blood cells or bone marrow suppression, and stop ACTL treatment;

  • III. Patients with stage IV tumors

    1. Patients who are receiving radiotherapy and chemotherapy are not recommended to receive ACTL treatment at the same time;

    2. For patients who are going to receive radiotherapy or chemotherapy, consider the following ACTL treatment plan, but pay attention to the obvious decline in the number of white blood cells or bone marrow suppression, and stop ACTL treatment;

    1. Patients who are receiving radiotherapy and chemotherapy are not recommended to receive ACTL treatment at the same time;

    2. For patients who are ready to receive radiotherapy or chemotherapy, consider the following ACTL treatment plan, but pay attention to the obvious decline in the number of white blood cells or bone marrow suppression, and stop ACTL treatment;

    1. Patients who are receiving radiotherapy and chemotherapy are not recommended to receive ACTL treatment at the same time;

    2. For patients who are going to receive radiotherapy or chemotherapy, consider the following ACTL treatment plan, but pay attention to the obvious decline in the number of white blood cells or bone marrow suppression, and stop ACTL treatment;

    1. Patients who are receiving radiotherapy and chemotherapy are not recommended to receive ACTL treatment at the same time;

    2. For patients who are going to receive radiotherapy or chemotherapy, consider the following ACTL treatment plan, but pay attention to the obvious decline in the number of white blood cells or bone marrow suppression, and stop ACTL treatment;

  • Patients who have finished radiotherapy and chemotherapy

    1. Patients who are receiving radiotherapy and chemotherapy are not recommended to receive ACTL treatment at the same time;

    2. For patients who are going to receive radiotherapy or chemotherapy, consider the following ACTL treatment plan, but pay attention to the obvious decline in the number of white blood cells or bone marrow suppression, and stop ACTL treatment;

    1. Patients who are receiving radiotherapy and chemotherapy are not recommended to receive ACTL treatment at the same time;

    2. For patients who are ready to receive radiotherapy or chemotherapy, consider the following ACTL treatment plan, but pay attention to the obvious decline in the number of white blood cells or bone marrow suppression, and stop ACTL treatment;

    1. Patients who are receiving radiotherapy and chemotherapy are not recommended to receive ACTL treatment at the same time;

    2. For patients who are going to receive radiotherapy or chemotherapy, consider the following ACTL treatment plan, but pay attention to the obvious decline in the number of white blood cells or bone marrow suppression, and stop ACTL treatment;

    1. Patients who are receiving radiotherapy and chemotherapy are not recommended to receive ACTL treatment at the same time;

    2. For patients who are going to receive radiotherapy or chemotherapy, consider the following ACTL treatment plan, but pay attention to the obvious decline in the number of white blood cells or bone marrow suppression, and stop ACTL treatment;

  • Patients receiving radiotherapy and chemotherapy

    1. Patients who are receiving radiotherapy and chemotherapy are not recommended to receive ACTL treatment at the same time;

    2. For patients who are going to receive radiotherapy or chemotherapy, consider the following ACTL treatment plan, but pay attention to the obvious decline in the number of white blood cells or bone marrow suppression, and stop ACTL treatment;

    1. Patients who are receiving radiotherapy and chemotherapy are not recommended to receive ACTL treatment at the same time;

    2. For patients who are ready to receive radiotherapy or chemotherapy, consider the following ACTL treatment plan, but pay attention to the obvious decline in the number of white blood cells or bone marrow suppression, and stop ACTL treatment;

    1. Patients who are receiving radiotherapy and chemotherapy are not recommended to receive ACTL treatment at the same time;

    2. For patients who are going to receive radiotherapy or chemotherapy, consider the following ACTL treatment plan, but pay attention to the obvious decline in the number of white blood cells or bone marrow suppression, and stop ACTL treatment;

    1. Patients who are receiving radiotherapy and chemotherapy are not recommended to receive ACTL treatment at the same time;

    2. For patients who are going to receive radiotherapy or chemotherapy, consider the following ACTL treatment plan, but pay attention to the obvious decline in the number of white blood cells or bone marrow suppression, and stop ACTL treatment;

  • Patients with severe disease and rapid progress

    1. Patients who are receiving radiotherapy and chemotherapy are not recommended to receive ACTL treatment at the same time;

    2. For patients who are going to receive radiotherapy or chemotherapy, consider the following ACTL treatment plan, but pay attention to the obvious decline in the number of white blood cells or bone marrow suppression, and stop ACTL treatment;

    1. Patients who are receiving radiotherapy and chemotherapy are not recommended to receive ACTL treatment at the same time;

    2. For patients who are ready to receive radiotherapy or chemotherapy, consider the following ACTL treatment plan, but pay attention to the obvious decline in the number of white blood cells or bone marrow suppression, and stop ACTL treatment;

    1. Patients who are receiving radiotherapy and chemotherapy are not recommended to receive ACTL treatment at the same time;

    2. For patients who are going to receive radiotherapy or chemotherapy, consider the following ACTL treatment plan, but pay attention to the obvious decline in the number of white blood cells or bone marrow suppression, and stop ACTL treatment;

    1. Patients who are receiving radiotherapy and chemotherapy are not recommended to receive ACTL treatment at the same time;

    2. For patients who are going to receive radiotherapy or chemotherapy, consider the following ACTL treatment plan, but pay attention to the obvious decline in the number of white blood cells or bone marrow suppression, and stop ACTL treatment;

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