丹参酮ⅡA成功治疗一例ATRA和ATO维持治疗复发的APL

A Successful Case of Tanshinone ⅡA Treatment for Relapsed Acute Promyelocytic Leukemia after Maintainance Therapy of All-trans Retinoic Acid and Arsenic Trioxide

目的观察丹参酮ⅡA(TanshinoneⅡA,TanⅡA)治疗耐全反式维甲酸(ATRA)和亚砷酸(ATO)的急性早幼粒细胞白血病(APL)的疗效。方法给1例经ATRA和ATO诱导和维持治疗复发的APL患者静脉滴注TanⅡA 80 mg/d,直至缓解,并定期检查患者血象和骨髓象,记录该药相关的不良反应。结果该例经ATRA与ATO诱导缓解、化疗巩固,并用ATRA、ATO、6-巯基嘌呤(6-MP)和甲氨蝶呤(MTX)维持治疗1年而复发的APL患者,先经ATRA与ATO 20 d再诱导无效并致头痛,改用TanⅡA 80 mg/d静脉滴注54 d达血液学完全缓解,且未见明显不良反应。结论 TanⅡA治疗耐ATRA和ATO的APL有效,为耐ATRA和ATO的APL的治疗提示了新的治疗途径。

Objective To observe the effects of Tanshinone Ⅱ A （Tan Ⅱ A） on acute promyelocytie leukemia （APL） characterized by resistance to all-trans retinoic acid （ATRA） and arsenic trioxide （ATO）. Methods A 21-year-old male patient with relapsed APL, who previously received the maintenance therapy with ATRA, ATO, 6-Mercaptopurine （6-MP） and Methotrexate （MTX） for 1 year, was given Tan Ⅱ A 80 mg intravenously once a day, and the changes of hematological parameters and side effects of Tan Ⅱ A were observed. Results The patient reached morphologically complete remission after using Tan Ⅱ A intravenously for 54 days. During Tan Ⅱ A treatment,obvious side effect was not observed. Conclusion Tan Ⅱ A treatment may be effective in relapsed APL cases with ATRA and ATO resistance.