维甲酸和三氧化二砷治疗急性早幼粒细胞白血病的现状

Treatment of acute promyelocytic leukemia with ATRA, arsenic trioxide

急性早幼粒细胞白血病 (APL)是具有生物学和临床特点的一种特殊类型急性髓细胞白血病。近年来全反式维甲酸 (ATRA)的应用极大地提高完全缓解率和减少了治疗相关死亡率。ATRA与化疗联合应用有助于降低复发率和延长生存期。三氧化二砷 (As2 O3 )治疗初治和复发APL已取得巨大成功。持续分子缓解是APL的治疗目标。早期发现分子复发并给予补救治疗 。

Acute promyelocytic leukemia(APL) is a specific type acute myeloid leukemia characterized by the specific morphology of blasts cells, t(15,17) translocation and PML/RARa fusion gene, and specific coagulopathy. All trans retinoic acid(ATRA) can differentiate APL blasts in vivo and in vitro . Treatment with RA followed by anthracycline AraC chemotherapy has improved the outcome of APL through slightly improving the complete remission(CR) rate, and more importantly by reducing the incidence of relapse to a larger degree. Arsenic trioxide treatment can lead to a high CR rate in both newly diagnosed and relapsed APL patients. Early administration of salvage therapy is advantageous in APL with molecular relapse. To produce a persistently molecular remission should be the goal of therapy of APL.