急性早幼粒细胞白血病68例回顾性临床分析

Retrospective clinical analysis of 68 cases in acute promyelocytic leukemia

目的探讨初治中低危急性早幼粒细胞白血病(APL)患者诱导缓解治疗及完全缓解(CR)后的治疗方案。方法回顾性分析68例初治APL患者3种不同诱导治疗方法CR率、达CR所需时间及副作用,并分析CR后不同巩固治疗方案对预后的影响。结果全返式维甲酸(ATRA)联合蒽环类药物化疗、单用亚砷酸(AS2O3)及ATRA+AS2O3+化疗3种方法治疗初诊APL完全缓解率分别为90%、89%、89%,无显著差异,P>0.05;ATRA+AS2O3+化疗组达CR所需时间最短,ATRA+化疗组副作用最少,P<0.05;CR后选用ATRA、AS2O3、化疗序贯治疗能明显延长患者无病生存期。结论 ATRA+化疗方案可做为初治APL患者诱导缓解的首选方案;ATRA、AS2O3、化疗序贯治疗均可做为CR后的有效治疗方案,中低危患者可不必联用Ara-c化疗。

To investigate the treatment options of inductive therapy and post complete remission（CR） therapy for patients with newly diagnosed acute promyelocytic leukemia（APL） in non-high risk group,retrospective study of 68 newly diagnosed APL patients was performed;the CR rate,the time to CR,the adverse reaction in three different inductive therapy group was analyzed,and the impact of different post-CR therapy on prognosis was analyzed.The complete remissiom rate of ATRA combined with anthracycline group、AS2O3 alone group、ATRA combined with AS2O3 and anthracycline group in the treatment of newly diagnosed APL was 90%、89%、89% respectively,which showed no significant difference,P0.05.ATRA combined with AS2O3 and anthracycline group had the shortest the time to CR;ATRA combined with antracycline group has the least side-effects.The analysis shows that TRA combination chemotherapy would be a choice for patients with newly diagnosed APL.The post-remissione sequential therapy consisting of ATRA、AS2O3 and chemothery would be favorable for designing effective therapeutic regimens in the management of APL,and would not combine with Ara-c in non-high risk group.