全反式维甲酸联合三氧化二砷治疗急性早幼粒细胞白血病29例观察

The Observation of Combination of Arsenic Trioxide and All Trans Retinoic Acid for the Treatment of 29 Patients with Acute Promyelocytic Leukemia

目的 观察全反式维甲酸 (ATRA)联合三氧化二砷 (As2 O3 )治疗急性早幼粒细胞白血病 (APL)的临床疗效、作用特点及毒副作用。方法 As2 O3 注射液 0 .16mg/ (kg·d) ,ATRA 2 5mg/ (m2 ·d)联合治疗初治APL 2 9例 ,根据外周血白细胞计数、维甲酸综合征以及肝功能变化调整ATRA和As2 O3 的剂量。治疗过程中每周检查血象、骨髓像 ,随机检查凝血纤溶指标和肝、肾功能、心电图。结果 治疗初治APL 2 9例 ,1例因并发颅内出血而早期死亡 ,其余 2 8例均达到CR ,完全缓解率 96.6% ,平均缓解时间 ( 2 6.3± 4.1)天。结论 As2 O3 联合ATRA治疗APL的CR率高 ,达CR时间缩短 ,不良反应少。

Objective To observe the therapeutic effects, character and toxicity of arsenic trioxide and all trans retinoic acid in treating patients with acute promyelocytic leukemia (APL). Methods As 2O 3 solution 0.16 mg/kg was administered intravenously daily and ATRA 25 mg/m 2 was given every day in treating 29 cases of previously treated patients. Bone marrow smear and peripheral blood count were performed each week. Parameters of coagulation and fibrinolysis and function of hepatic and nephric were measured during the course.Results To treat 29 patients with acute promyelocytic leukemia (APL), one patient died early after the treatment due to intracranial hemorrhage, the other 28(96.6%) achieved CR. The average time for achieving CR was (26.3±4.1)days.Conclusions ATRA combined with As 2O 3 in the APL treatment can yield a high CR rate. The average time to achieve CR was shortened, and the intolerable side effects were decreased.