亚砷酸联合维甲酸治疗急性早幼粒细胞白血病6年临床观察

The clinical observation on arsenic trioxide associated with ATRA in treating acute promyelocytic leukemia for six years

目的:观察亚砷酸(AS2O3)联合维甲酸(ATRA)治疗急性早幼粒细胞白血病(APL)的疗效和特点。方法:对APL住院患者随机分为2组,治疗组38例,单纯AS2O3加ATRA,从诱导治疗、巩固治疗到停药观察6年。对照组36例,AS2O3加ATRA加化疗(DA或MA),观察6年。结果:治疗组38例,初治诱导缓解治疗达完全缓解率(CR)为100%。3年复发率为2.6%,6年持续缓解率(CCR)为94.6%。对照组36例初治诱导缓解率为81.3%,3年复发率为30.7%,6年CCR为61.5%。治疗相关不良反应治疗组比对照组较轻而少(P<0.01),3年治疗相关死亡率为0,而对照组为16.7%(6/36)。结论:亚砷酸联合维甲酸治疗APL,具有协同增强作用,疗效高,复发率低,治疗相关不良反应少,未见耐药性产生。

Objective：To observe the effectiveness and the feature of arsenic trioxide （AS2O3） associated with ATRA in treating acute promyelocytic leukemia （APL）. Method： Seventy-four cases of APL was provided randomly into two groups. Thirty-eight cases in treating group with AS2O3＋ATRA,thiry-six cases in control group with AS2O3 ＋ATRA＋ chemotherapy （DA or MA）. The observation was lasted for six years. Result： The first induce complete remission （CR） is 100~, the 3 years relapse rate is 2.6%, 6 years keep on alleviating rate （CCR） is 94.6% in the treating group. CR is 81.3%,3 years relapse rate is 30.7% ,CCR of 6 years is 61.5% in the control group. Bad reaction related to the treatment were lighter and less in the treacting group than in the control group. The three-year death rate respond to treating is 0 in treat group,while 16.7% （3/6） in control group. Conclusion： Arsenic trioxide associated with ATRA had strenger Synergy effect higher curative effect, lower relapse rate and lower side effect, and the resistance have not been seen.