全反式维甲酸联合三氧化二砷治疗初发急性早幼粒细胞白血病的疗效观察

Clinical observation of the efficacy of the treatment with combination of all-trans retinoic acid(ATRA) and arsenic trioxide(As_2O_3) in newly diagnosed acute promyelocytic leukemia(APL)

目的观察全反式维甲酸(ATRA)联合三氧化二砷(As2O3)治疗急性早幼粒细胞白血病(APL)的完全缓解(CR)率和不良反应。方法ATRA25mg.m-2.d-1,As2O3(0.1%溶液)10mL/d联合治疗初发APL直至CR。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As2O3的剂量。结果29例初发APL患者,早期死亡2例,27例获得CR,CR率93.1%。获得CR的平均时间为(25.2±3.5)d。没有发现严重不良反应。结论ATRA联合As2O3治疗初发APL疗效好,不良反应患者能耐受。

Objective To observe the efficacy and side effect of the All-trans retinoic acid(ATRA) combined with arsenic trioxide(As_2O_3) in acute promyelocytic leukemia(APL) treatment. Methods Twenty nine newly diagnosed APL Patients of whom 13 were females, 16 were males and the median age was 35 years entered into the study. They were treated with ARTA 25 mgm^(-2)d^(-1) combined with 10 mL As_2O_3(0.1% solution) until complete remission(CR). The dose was adjusted according to white blood cell(WBC) counts, occurrence of retinoic acid syndrome and the status of liver function. Results Two patients died 1 week after the treatment because of intracranial hemorrhage, and 27(93.1%) achieved CR. The average time of achieving CR was (25.23.5)d. No severe side effect was observed. Conclusion As_2O_3 combined with ATRA in the treatment of APL can obtain a higher CR rate and a shorter duration for achieving CR without intolerable side effect.