三氧化二砷治疗急性早幼粒细胞白血病的研究现状

The current research of arsenic trioxide in the treatment of acute promyelocytic leukemia

三氧化二砷（Arsenictrioxide，ATO）是目前单药治疗急性早幼粒细胞白血病（Acutepromye—loeyticleukemia，APL）最有效的药物之一，可明显提高APL的完全缓解率，延长患者的生存期，且不良反应较轻。ATO的作用机制主要为诱导APL细胞分化与凋亡、促使细胞内活性氧水平升高和去除白血病启动细胞等，并且在诱导分化和凋亡方面与全反式维甲酸起协同作用。对于复发性APL，以ATO为基础的挽救疗法能够诱导APL长期缓解并且50％～81％的患者可能治愈。在初发APL中，ATO表现出抗白血病的高效性和低毒性，使APL获得较高的缓解率和治愈率。因此，对ATO进行深入的基础及临床研究将为进一步优化ATO对APL的治疗提供重要的参考。

Arsenic trioxide （ATO） is presently one of the most effective single agent in the treatment of a- cute promyelocytic leukemia（APL）. ATO impressivly increases the complete remission rate and prolongs survival of patients with APL with only mild and transient adverse effects. The mechanisms of ATO mainly include promo- ting differentiation, inducing apoptosis, accumulating reactive oxygen species, and eliminating leukemic - initiating cells. And synergistic actions in introduction of apoptosis and differentiation between ATO and all - trans - retino- ic acid have been shown. In relapsed APL, ATO - based salvage therapy has been able to induce long - lasting re- missions and possible cure in 50% - 81% of patients. The high anti - leukemic efficacy and the favorable toxicity profile of ATO were also shown in newly diagnosed APL, because high remission and cure rates could even be in- duced by ATO alone. Experimental research and clinical studies have established ATO as an important candidate for the further improvement of APL therapy.