全反式维甲酸和三氧化二砷治疗初治急性早幼粒细胞白血病的疗效观察

Effect observation of all-trans retinoic acid,arsenic trioxide combined with chemotherapy in treatment of acute promyelocytic leukemia

目的观察全反式维甲酸(ATRA)联合三氧化二砷(As2O3)治疗初治急性早幼粒细胞白血病(APL)的疗效。方法对应用ATRA和As2O3联合诱导治疗的20例APL患者的完全缓解(CR)率、达CR所需时间和不良反应进行观察,并与单独应用ATRA组30例进行比较。联合用药组治疗方法为ATRA 25mg/(m2.d),0.1%As2O310ml/d直至CR。结果联合用药组与单独应用ATRA组相比,CR率差异无统计学意义(分别为95%、86.7%,均P>0.05);联合用药组获得CR所需的时间短于单独用药组(平均时间分别为24d、45d,均P<0.05),早期死亡率较单独用药组差异无统计学意义(分别为5%、13.3%,均P>0.05);与单独用药组相比,联合用药组的不良反应并未增加。结论联合用药诱导初发APL缓解的疗效优于单用药组,不良反应少,是一种值得推广应用的方案。

Objective To observe the effect of all -trans retinoic acid （ATRA） combined arsenic trioxide （As2O3 ） in early treatment of acute promyelocytic leukemia （APL）. Methods The combined application of ATRA and As2O3 in- duction therapy, 20 patients with APL in complete remission （CR） rate, CR time and adverse events were observed, and with ATRA alone, 30 patients were compared. Combination therapy group treatment for ATRA25mg/（ m^2·d）, 0. 1% As2 03 10ml / d until CR. Results The combined treatment group compared with ATRA alone, CR rates of the difference was not statistically significant （ respectively 95%, 86. 7%, both P 〉 0.05 ） ; The combination group a- chieved CR shorter than the time required for a single treatment group （The average time was 24d, 45d, both P 〈 0.05 ）, early mortality compared with single treatment group difference was not statistically significant （5%, respective- ly, 13. 3%, respectively, P 〉 0. 05） ; Compared with monotherapy, combination therapy group did not increase adverse events. Conclusions The combination therapy induced remission in primary APL effective than single -treatment group, adverse reactions less, which is a worthy application program.