急性早幼粒细胞性白血病:全反式维甲酸诱导分化治疗中出血并发症的处理

Acute Promyelocytic Leukemia:Management of Bleeding Complication in all-Trans Retinoic Acid Induced Differentiation

16例急性早幼粒细胞性白血病(APL)采用全反式维甲酸(RA)进行诱导分化治疗。入院时和病程中80%(13/16例)的患者发生弥散性血管内凝血(DIC),4例发生严重出血。经配合包括肝素抗凝、新鲜血及血小板输注,并用地塞米松、脱水和防治感染等积极的综合性治疗,渡过危险期,有效保障 RA 诱导分化作用的发挥,全部病例取得骨髓完全缓解.

16 cases of acute promyelocytic leukemia(APL)treated with differentiation induction by all-trans retinoic acid(RA)were reported in the present paper.80%(13/16 cases)patients developed disseminated intra- vascular coagulation(DIC)at the admission and/or in the course of treat- ment,25%(4/16 cases)severe hemorrhage.All patients received by synthetical treatment including low dose heparin,fresh blood and platelets transfu- sion,dexamethasone,dehydration and antibiotics,which ensured effectively to RA brought into play role of differentiation induction.All patients achieved complete remission in the bone marrow.