三联方案治疗初诊急性早幼粒细胞白血病临床效果分析

Analysis of clinical effect of acute promyelocytic leukemia treated by the combination of 3 drugs

目的观察全反式维甲酸(ATRA)、亚砷酸(ATO)及柔红霉素(DNR)三联方案治疗急性早幼粒性白血病(APL)的疗效及安全性。方法将61例采用四种不同诱导方案治疗的临床初诊APL患者根据化疗方案不同分为四组,其中采用ATRA+ATO+DNR者为观察组、ATO+DNR者为对照1组、ATRA+DNR者为对照2组、DNR+阿糖胞苷(Ara-c)为对照3组,对完全缓解(CR)率、病死率及毒副作用进行回顾性分析。结果观察组CR率显著高于其他三组,病死率显著低于对照3组,高白细胞血症持续时间显著短于对照1、2组,与对照1、2组比较维甲酸综合征(RAS)发生率无明显差异,肝功能损伤(均为可逆性)发生率显著高于其他三组。结论 ATRA、ATO及DNR三联方案治疗初诊APL患者疗效显著,且安全性较高。

Objective To observe the efficacy and safety of acute promylocytic leuk emia（APL） treated by the combination of 3 drugs including all-trans retinoic ac id（ATRA）,arsenic trioxide（ATO） and daunorubicin（DNR）.Methods Based on differen t induction regimen,61 newly diagnosed APL patients were divided into four grou ps.Observation group was treated by ATRA＋ATO＋DNR,control group 1 by ATO＋DNR,c ontrol group 2 by ATRA＋DNR and control group 3 by DNR＋cytosine arabinoside（Arac）.The complete remission（CR） rates,mortality and side effects were retrospec tively analyzed.Results The remission rate of observation group was significant ly higher than that of the other three groups and the mortality was lower than t hat of the control group 3.Duration of high white blood cell viremia of observat ion group was shorter than that of control group 1 and 2.The rates of RAS had n o significant difference between observation group,control group 1 and 2.The r eversibility liver dysfunction of observation group was the highest in the four groups.Conclusions The effect of newly diagnosed APL treated by the combination of 3 drugs including ATRA,ATO and DNR is effective and security.